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General NPI Number Information
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NPI Number | 1104868876
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Entity Type | Organization
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Legal Business Name | SOUTHEAST VOLUSIA MEDICAL SERVICES INC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 12/19/2008
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Provider Practice Location Address
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Address Line | 401 PALMETTO ST
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-7322
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Country | US
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Telephone | 386-424-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 919246
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City | ORLANDO
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State | FL
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Zip | 32891-9246
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Country | US
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Telephone | 386-424-5000
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Fax |
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Authorized Official
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Title or Position | CPA FO
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Name | MR. AL ALLRED
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Credential |
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Telephone | 386-424-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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