Organization
SSP MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEX KHROMOV M.D. (PRESIDENT)
(386) 742-4343
Entity
Organization
Contact information
Practice address
1565 SAXON BLVD, SUITE 204, DELTONA, FL 32725-5876
(386) 742-4343
Mailing address
1565 SAXON BLVD, SUITE 204, DELTONA, FL 32725-5876
(386) 742-4343
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME96564
FL
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
ME96564
FL
Other
Enumeration date
12/04/2008
Last updated
12/10/2008
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