NEW SMYRNA BEACH AMBULATORY CARE CENTER INC NPI 1902853195

NPI Information

NPI: 1902853195
Provider Name: NEW SMYRNA BEACH AMBULATORY CARE CENTER INC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D0918918

Address:
612 PALMETTO ST
NEW SMYRNA BEACH, FL
ZIP 32168
Phone: (386) 423-5500
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NEW SMYRNA BEACH AMBULATORY CARE CENTER INC is an ambulatory surgical clinic center in New Smyrna Beach, FL. NEW SMYRNA BEACH AMBULATORY CARE CENTER INC NPI is 1902853195. The provider is registered as an organization entity type.

The provider's business location address is:

612 PALMETTO ST
NEW SMYRNA BEACH, FL
ZIP 32168-327
Phone: (386) 423-5500

The provider's authorized official is Mark Nagrani .
The authorized official title is Medical Director and has the following contact phone number (386) 423-5500.

The CLIA number assigned to this NPI record is 10D0918918 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 6/26/2014.

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	261QA1903X	Clinic/Center	Ambulatory Surgical	1017	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	079118100	MEDICAID	FLORIDA
2	F1180	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA

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: 5/5/2024

NPI Synchronization or Removal

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