Organization
AJD MEDICAL LLC
Active
Other names
Antonio J Decarli, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONTIO J DECARLI M.D. (PRESIDENT)
(386) 423-5500
Entity
Organization
Contact information
Practice address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 423-5500
(386) 409-9762
Mailing address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 423-5500
(386) 409-9762
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000749600
—
FL
Enumeration date
04/08/2009
Last updated
08/12/2010
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