PCCC OF VOLUSIA LLC
Osteopathic Medicine at Dixie Fwy, New Smyrna, FL

License number
Florida ME89115
Category
Osteopathic Medicine
Type
Critical Care Medicine
License number
Florida ME89115
Category
Osteopathic Medicine
Type
Pulmonary Disease
Owner
Name: RAJESH K AILANI MD
Title: MD
Phone: (386) 423-0505
Address
Address
1055 N Dixie Fwy SUITE 1, New Smyrna, FL 32168
National Provider ID: 1285685370
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about PCCC OF VOLUSIA LLC at bizstanding.com

PCCC OF VOLUSIA LLC

New Smyrna, FL  -  Daytona Beach, FL

Status:
Inactive
Industry:
Offices and Clinics of Medical Doctors, Nsk
Doing business as:
PCCC of Volusia
Inactive reason:
LC STMNT OF AUTHORITY 21
Registration:
Jan 26, 2004
Inactive since:
Jan 20, 2015
Phone:
(386) 423-0505 (Phone)
Addresses:
1055 N Dixie Fwy, New Smyrna Beach, FL 32168 (Physical)
6600 Merryvale Ln, Daytona Beach, FL 32128
6667 Merryvale Ln, Daytona Beach, FL 32128
State ID:
L04000006637
Business type:
Florida Limited Liability Company
Managing Member:
Rajesh Ailani (Managing Member), 1055 N Dixie Fwy, New Smyrna Beach, FL 32168 (Physical)
EIN:
20-0604706

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