| Ndc Of Volusia Llc | |
|
1055 N Dixie Fwy Suite 1 New Smyrna Beach FL 32168-6201 | |
| (386) 423-0505 | |
| (386) 423-0515 |
| Full Name | Ndc Of Volusia Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1055 N Dixie Fwy, New Smyrna Beach, Florida |
| Authorized Official Name and Position | Rajesh K Ailani (OWNER) |
| Authorized Official Contact | 3864230505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ndc Of Volusia Llc 1055 N Dixie Fwy Suite 1 New Smyrna Beach FL 32168-6201 Ph: (386) 423-0505 | Ndc Of Volusia Llc 1055 N Dixie Fwy Suite 1 New Smyrna Beach FL 32168-6201 Ph: (386) 423-0505 |
| NPI Number | 1053759183 |
|---|---|
| Provider Enumeration Date | 06/11/2013 |
| Last Update Date | 03/13/2014 |
| Medicare PECOS PAC ID | 6305088436 |
|---|---|
| Medicare Enrollment ID | O20130820000256 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053759183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME73099 (Florida) | Primary |
| Provider Name | Vicente C Trapani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710975073 PECOS PAC ID: 0446492581 Enrollment ID: I20130820000326 |
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