Provider Demographics
NPI:1740618875
Name:ISLAND DOCTORS OF NEW SMYRNA BEACH MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:ISLAND DOCTORS OF NEW SMYRNA BEACH MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-662-5200
Mailing Address - Street 1:4960 SW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5544
Mailing Address - Country:US
Mailing Address - Phone:305-662-5200
Mailing Address - Fax:305-284-7913
Practice Address - Street 1:406 PALMETTO ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW SMYRNA
Practice Address - State:FL
Practice Address - Zip Code:32168-7323
Practice Address - Country:US
Practice Address - Phone:386-423-1212
Practice Address - Fax:386-423-5730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty