institution
Riviera Plaza Medical Office Llc
Primary Care Clinic/Center in Holly Hill, Florida
NPI 1013338144

Riviera Plaza Medical Office Llc is a Primary Care Clinic/Center based in Daytona Beach, FL and is specialized in Primary Care. Riviera Plaza Medical Office Llc practices in Holly Hill, FL. The NPI Number for Riviera Plaza Medical Office Llc is 1013338144 and holds a License No. ME47765 (Florida).

The current practice location address for Riviera Plaza Medical Office Llc is 1702 Ridgewood Ave, Holly Hill, FL and can be reached out via phone at 386-677-5415 and via fax at 386-677-1475. You can also correspond with Riviera Plaza Medical Office Llc through the mailing address at 208 N HALIFAX AVE, DAYTONA BEACH, FL - 32118-4159 (mailing address contact number: 386-677-5415).

Location: 1702 Ridgewood Ave, Holly Hill, FL, 32118-4159
institution
Provider Profile Details
NPI Number
1013338144
Provider Name
Riviera Plaza Medical Office Llc
Credential
Provider Entity Type
Organization
Address
1702 Ridgewood Ave, Holly Hill, FL, 32118-4159
Phone Number
386-677-5415
Fax Number
386-677-1475
Provider Enumeration Date
12/16/2013
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
042193600 05 FL
HS776A 01 FL MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
1702 Ridgewood Ave
City
State
Zip
32117-5416
Phone Number
386-677-5415
Fax Number
386-677-1475
person
Provider Business Mailing Address Details
Address
1702 Ridgewood Ave
City
State
Zip
32117-5416
Phone Number
386-677-5415
Fax Number
386-677-1475
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
ME47765 (Florida)
Definition
Definition to come...
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