Organization
IPS OF NEW SMYRNA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R. NOBACK MD (MEDICAL DIRECTOR)
(941) 360-1566
Entity
Organization
Contact information
Practice address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 423-5500
Mailing address
PO BOX 864483, ORLANDO, FL 32886-4483
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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