MEDICARE: PREFERRED INJURY PHYSICIANS OF NEW SMYRNA BEACH, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1386113942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED INJURY PHYSICIANS OF NEW SMYRNA BEACH, INC

Provider Business Mailing Address
First Line	:	1355 OAKFIELD DR
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4841
Country	:	US
Telephone Number	:	813-785-5958
Fax Number	:

Provider Business Practice Location Address
First Line	:	658 N DIXIE FWY
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-6466
Country	:	US
Telephone Number	:	386-265-7246
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MARIA GIL
Credential	:
Telephone Number	:	813-785-5958

Provider Enumeration Date	:	11/13/2018
Last Update Date	:	11/13/2018

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