MEDICARE: VOLUSIA NEUROSURGICAL ASSOCIATES

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	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1932672912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOLUSIA NEUROSURGICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	311 N CLYDE MORRIS BLVD STE 440
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-2757
Country	:	US
Telephone Number	:	386-562-7224
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 N CLYDE MORRIS BLVD STE 440
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-2757
Country	:	US
Telephone Number	:	386-562-7224
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/OWNER
Name	:	FEDERICO CARLOS VINAS
Credential	:	MD
Telephone Number	:	386-562-7224

Provider Enumeration Date	:	01/02/2019
Last Update Date	:	01/02/2019

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