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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