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Organization
NEW SMYRNA BEACH AMBULATORY CARE CENTER
Active
Organization
NEW SMYRNA BEACH AMBULATORY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK NAGRANI M.D. (MEDICAL DIRECTOR)
(386) 423-5500
Entity
Organization
Contact information
Practice address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(383) 423-5500
(386) 409-9762
Mailing address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(383) 423-5500
(386) 409-9762
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1017
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63D
BCBS PROVIDER NUMBER
FL
Enumeration date
01/29/2007
Last updated
08/22/2020
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