| Southeast Volusia Healthcare Corporation | |
|
600 Palmetto St New Smyrna Beach FL 32168-7327 | |
| (386) 424-5000 | |
| Not Available |
| Full Name | Southeast Volusia Healthcare Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 600 Palmetto St, New Smyrna Beach, Florida |
| Authorized Official Name and Position | Mark Rathbun (CFO) |
| Authorized Official Contact | 3864245230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Volusia Healthcare Corporation Po Box 864623 Orlando FL 32886-4623 Ph: (386) 671-4519 | Southeast Volusia Healthcare Corporation 600 Palmetto St New Smyrna Beach FL 32168-7327 Ph: (386) 424-5000 |
| NPI Number | 1710346093 |
|---|---|
| Provider Enumeration Date | 02/16/2016 |
| Last Update Date | 03/03/2021 |
| Medicare PECOS PAC ID | 3870887953 |
|---|---|
| Medicare Enrollment ID | O20160818000209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710346093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Taher Khalil |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821012113 PECOS PAC ID: 4284521881 Enrollment ID: I20040228000449 |
| Provider Name | Arthur W Wilkinson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396719571 PECOS PAC ID: 4880669787 Enrollment ID: I20040901001120 |
| Provider Name | Frank W Toub |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336171917 PECOS PAC ID: 8426008608 Enrollment ID: I20050125001061 |
| Provider Name | Albert J Razzetti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770541062 PECOS PAC ID: 1456383637 Enrollment ID: I20050912000094 |
| Provider Name | Ravi Rao |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245288505 PECOS PAC ID: 0345234860 Enrollment ID: I20070208000598 |
| Provider Name | Surya P Rao |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114975596 PECOS PAC ID: 7810946662 Enrollment ID: I20070208000602 |
| Provider Name | Wing Yi Liu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609907948 PECOS PAC ID: 9335235795 Enrollment ID: I20071016000194 |
| Provider Name | Kimberly Anne Keller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366481483 PECOS PAC ID: 7315995909 Enrollment ID: I20080618000253 |
| Provider Name | Eric Lup-sing Lo |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1497782023 PECOS PAC ID: 8123193208 Enrollment ID: I20080825000438 |
| Provider Name | Huijian J Wang |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1043488661 PECOS PAC ID: 1153497581 Enrollment ID: I20080908000494 |
| Provider Name | Tina L Fischer Carne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912995499 PECOS PAC ID: 2062508690 Enrollment ID: I20101101000196 |
| Provider Name | Adel Y Daas |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518049964 PECOS PAC ID: 3779751144 Enrollment ID: I20110729000622 |
| Provider Name | Gregory G White |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851368377 PECOS PAC ID: 1658260286 Enrollment ID: I20130207000320 |
| Provider Name | Kathryn M Malan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740575497 PECOS PAC ID: 5496992778 Enrollment ID: I20130812000482 |
| Provider Name | Rebecca Gill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215134820 PECOS PAC ID: 2062690365 Enrollment ID: I20170918001576 |
| Provider Name | Susan Stovall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851727069 PECOS PAC ID: 6800962226 Enrollment ID: I20200210000094 |
| Provider Name | Maria Caratas Epstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457714818 PECOS PAC ID: 1355671173 Enrollment ID: I20200821001673 |
| Provider Name | Willy Alberto Bustinza Farfan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023455508 PECOS PAC ID: 0749580033 Enrollment ID: I20220524003340 |
| Provider Name | Ron Rosenberg |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1598253825 PECOS PAC ID: 8325420581 Enrollment ID: I20220804000567 |
| Provider Name | Gary Fishman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1831138304 PECOS PAC ID: 9537124250 Enrollment ID: I20230406000515 |
| Provider Name | Mark Charles Duber |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881896033 PECOS PAC ID: 6406955996 Enrollment ID: I20230607003052 |
| Provider Name | Garly Rushler Saint Croix |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477917318 PECOS PAC ID: 7012376882 Enrollment ID: I20230711003898 |
| Provider Name | Crystal Dawn Geiger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225728272 PECOS PAC ID: 2062872112 Enrollment ID: I20230720002131 |
| Provider Name | Lauren Jane Honerlaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871366161 PECOS PAC ID: 4486097060 Enrollment ID: I20240212000066 |
Greg J. Mercurio, Md, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1720 State Road 44, New Smyrna Beach, FL 32168 Phone: 386-427-8008 Fax: 386-402-4309 | |
Metcare Of Florida Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1722 State Road 44, New Smyrna Beach, FL 32168 Phone: 386-428-3241 Fax: 986-427-8440 | |
Russell E. Perry, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 406 Palmetto St Ste A, New Smyrna Beach, FL 32168 Phone: 386-423-1212 Fax: 386-423-5730 | |
Mark K Nagrani Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 612 Palmetto St, New Smyrna Beach, FL 32168 Phone: 386-423-5500 Fax: 800-813-9164 | |
Idc Of Volusia, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 Palmetto St, New Smyrna Beach, FL 32168 Phone: 386-410-4981 Fax: 386-410-4982 | |
Better Life Medical Clinic Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1704 State Road 44, New Smyrna Beach, FL 32168 Phone: 386-402-4147 | |
South Volusia Medical Assoc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 S Dixie Fwy, New Smyrna Beach, FL 32168 Phone: 386-426-8600 Fax: 386-426-6090 |