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General NPI Number Information
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NPI Number | 1417026303
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL NON SELECTIVE BUSINESS SYSTEMS INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4270 ALOMA AVE STE 124
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City | WINTER PARK
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State | FL
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Zip | 32792-9388
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Country | US
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Telephone | 407-497-3096
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Fax | 407-677-0543
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Provider Business Mailing Address
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Address Line | PO BOX 953908
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City | LAKE MARY
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State | FL
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Zip | 32795-3908
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Country | US
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Telephone | 407-328-0825
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Fax | 407-322-5478
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Authorized Official
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Title or Position | CEO
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Name | DR. LADISLAV LEE V SMYK
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Credential | MD
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Telephone | 407-497-3096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME0051452
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License Number State | FL
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