Provider Demographics
NPI:1629279138
Name:VOLUSIA MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:VOLUSIA MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-424-1584
Mailing Address - Street 1:3900 CLARK RD STE L2
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2375
Mailing Address - Country:US
Mailing Address - Phone:386-424-1584
Mailing Address - Fax:888-900-7145
Practice Address - Street 1:3900 CLARK RD STE L2
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:386-424-1584
Practice Address - Fax:888-215-5481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty