Healthcare Provider Details

I. General information

NPI: 1891472395
Provider Name (Legal Business Name): SMA HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 SW MARTIN LUTHER KING JR AVE BLDG 2
OCALA FL
34471-1435
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:
Mailing address:
  • Phone: 386-236-3215
  • Fax: 386-236-3178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

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