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MEMORIAL HEALTH SYSTEMS INC NPI 1922115914


NPI Information

NPI: 1922115914
Provider Name: MEMORIAL HEALTH SYSTEMS INC

Doing Business As: ADVENTHEALTH MEDICAL GROUP

Classification: Surgery - 208600000X
Entity Type: Organization

CLIA Number: 10D0874019

Address:
305 MEMORIAL MEDICAL PKWY STE 205
DAYTONA BEACH, FL
ZIP 32117
Phone: (386) 231-3530
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MEMORIAL HEALTH SYSTEMS INC is a surgery in Daytona Beach, FL. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. MEMORIAL HEALTH SYSTEMS INC NPI is 1922115914. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Adventhealth Medical Group.

The provider's business location address is:

305 MEMORIAL MEDICAL PKWY STE 205
DAYTONA BEACH, FL
ZIP 32117-169
Phone: (386) 231-3530

The provider's authorized official is Cory Domayer .
The authorized official title is Cfo and has the following contact phone number (386) 231-3906.

The CLIA number assigned to this NPI record is 10D0874019 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2006 and was last updated on 4/28/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyNo
2207Q00000XFamily MedicineNo
3207RP1001XInternal MedicinePulmonary DiseaseNo
4207V00000XObstetrics & GynecologyNo
5208600000XSurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
140181JOTHERFLORIDAMEDICARE ID UNSPECIFIED

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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