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NPI Code Detail

MEDICARE: SMA HEALTHCARE INC

MEDICARE: SMA HEALTHCARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility0718AD5986-41FL

General Provider Information

NPI Number : 1487955977
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMA HEALTHCARE INC
Provider Business Mailing Address
First Line : 150 MAGNOLIA AVE
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-4304
Country : US
Telephone Number : 386-236-3200
Fax Number : 386-236-3178
Provider Business Practice Location Address
First Line : 301 JUSTICE LN
Second Line :
City : BUNNELL
State : FL
Zip : 32110-4487
Country : US
Telephone Number : 800-478-0331
Fax Number : 386-236-3178
Authorized Official
Title or Position : CEO/PRESIDENT
Name : MR. IVAN A COSIMI
Credential :
Telephone Number : 386-236-1811
Provider Enumeration Date : 11/15/2010
Last Update Date : 02/05/2026

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Directions to “SMA HEALTHCARE INC ” Practice Location

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