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General NPI Number Information
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NPI Number | 1245275734
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Entity Type | Organization
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Legal Business Name | BERT FISH MEDICAL CENTER INC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 05/15/2015
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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 | 401 PALMETTO ST P.O. BOX 1350
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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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Authorized Official
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Title or Position | CFO
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Name | MR. AL ALLRED
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Credential |
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Telephone | 386-424-5261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 4054
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License Number State | FL
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