Organization
SHORESIDE MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACI LW POSTELL (CEO)
(386) 316-4111
Entity
Organization
Contact information
Practice address
419 EAST THIRD AVE, NEW SMYRNA BEACH, FL 32169
(386) 957-3800
(386) 426-5939
Mailing address
449 ROCKEFELLER DR, NEW SMYRNA, FL 32168-8937
(386) 957-3800
(386) 426-5939
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS8699
FL
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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