PCCC OF VOLUSIA LLC NPI 1285685370

NPI Information

NPI: 1285685370
Provider Name: PCCC OF VOLUSIA LLC
Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

CLIA Number: 10D1092928

Address:
1055 N DIXIE FWY
SUITE 1
NEW SMYRNA BEACH, FL
ZIP 32168
Phone: (386) 423-0505
Get Directions

PCCC OF VOLUSIA LLC is a pulmonary disease internal medicine in New Smyrna Beach, FL. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. PCCC OF VOLUSIA LLC NPI is 1285685370. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1055 N DIXIE FWY
SUITE 1
NEW SMYRNA BEACH, FL
ZIP 32168-201
Phone: (386) 423-0505
Fax: (386) 423-0515

The provider's authorized official is Rajesh K Ailani .
The authorized official title is Md and has the following contact phone number (386) 423-0505.

The CLIA number assigned to this NPI record is 10D1092928 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/13/2006 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RS0012X	Internal Medicine	Sleep Medicine			No
2	207RC0200X	Internal Medicine	Critical Care Medicine	ME89115	FLORIDA	No
3	207RP1001X	Internal Medicine	Pulmonary Disease	ME89115	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	FLORIDA	TAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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