IDC OF VOLUSIA, LLC
Osteopathic Medicine at Palmetto St, New Smyrna, FL

License number
Florida ME89116
Category
Osteopathic Medicine
Type
Infectious Disease
Owner
Name: DR. REBA ISAAC MD
Title: MD
Phone: (386) 410-4981
Address
Address
410 Palmetto St, New Smyrna, FL 32168
National Provider ID: 1154372241
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about IDC OF VOLUSIA, LLC at bizstanding.com

IDC OF VOLUSIA LLC

New Smyrna, FL  -  Daytona Beach, FL

Industry:
Nonclassifiable Establishments
Registration:
Jan 26, 2004
Addresses:
410 Palmetto St, New Smyrna Beach, FL 32168 (Physical)
New Smyrna Beach, FL 32170 (Mailing)
6667 Merryvale Ln, Daytona Beach, FL 32128
PO Box 70, New Smyrna, FL 32170
State ID:
L04000006638
Business type:
Florida Limited Liability Company
Managing Members:
Reba K Isaac (Managing Member), 6667 Merryvale Ln, Port Orange, FL 32128 (Physical),Jeffrey A Rundall,Reba Ailani Managing Member, inactive
Agent:
Reba Isaac,6667 Merryvale Ln, Port Orange, FL 32128 (Physical)
EIN:
200604761

Osteopathic Medicine licenses in Florida










Other Doctors licenses in Florida