Healthcare Provider Details

I. General information

NPI: 1164094405
Provider Name (Legal Business Name): SMA HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5664 SW 60TH AVE
OCALA FL
34474-5677
US

IV. Provider business mailing address

150 MAGNOLIA AVE
DAYTONA BEACH FL
32114-4304
US

V. Phone/Fax

Practice location:
  • Phone: 352-291-5555
  • Fax:
Mailing address:
  • Phone: 386-236-3215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. IVAN COSIMI
Title or Position: CEO
Credential:
Phone: 386-236-1811