Healthcare Provider Details

I. General information

NPI: 1447189998
Provider Name (Legal Business Name): SMA HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 JUSTICE LN
BUNNELL FL
32110-4487
US

IV. Provider business mailing address

150 MAGNOLIA AVE
DAYTONA BEACH FL
32114-4304
US

V. Phone/Fax

Practice location:
  • Phone: 800-539-4228
  • Fax: 386-236-3230
Mailing address:
  • Phone: 800-539-4228
  • Fax: 386-236-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: KEVIN BUNN
Title or Position: CONTRACTING MANAGER
Credential:
Phone: 386-236-3273