Provider Demographics
NPI:1417026303
Name:INTERNATIONAL NON SELECTIVE BUSINESS SYSTEMS INC
Entity Type:Organization
Organization Name:INTERNATIONAL NON SELECTIVE BUSINESS SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LADISLAV LEE
Authorized Official - Middle Name:V
Authorized Official - Last Name:SMYK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-497-3096
Mailing Address - Street 1:PO BOX 953908
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-3908
Mailing Address - Country:US
Mailing Address - Phone:407-328-0825
Mailing Address - Fax:407-322-5478
Practice Address - Street 1:4270 ALOMA AVE STE 124
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9388
Practice Address - Country:US
Practice Address - Phone:407-497-3096
Practice Address - Fax:407-677-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051452208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04676Medicare ID - Type Unspecified