NPIMap

Organization Active NPI

Southeast Volusia Medical Services Inc

Doing business as Bert Fish Medical Center

  • Surgery Physician
  • New Smyrna Beach, FL
National Provider Identifier
1104868876
Registry record updated Dec 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SOUTHEAST VOLUSIA MEDICAL SERVICES INC
Doing business as
Bert Fish Medical Center
Practice address
401 Palmetto St
New Smyrna Beach, FL 32168-7322
Phone
(386) 424-5000
NPI assigned
Jun 10, 2006
Last updated
Dec 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Al Allred
Title
Cpa Fo
Phone
(386) 424-5000

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

401 Palmetto St
New Smyrna Beach, FL 32168-7322

Mailing address

PO Box 919246
Orlando, FL 32891-9246
Phone (386) 424-5000

Other names 1

  • Bert Fish Medical Center Doing business as

National Provider Directory

National Provider Directory

Locations

406 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 427-6791

600 Palmetto St
#1
New Smyrna Beach, FL 32168
Phone (386) 424-5000

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229644800000",
    "number": "1104868876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919246",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919246",
            "telephone_number": "386-424-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687322",
            "telephone_number": "386-424-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST VOLUSIA MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-12-19",
        "status": "A",
        "authorized_official_last_name": "ALLRED",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "CPA FO",
        "authorized_official_telephone_number": "386-424-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bert Fish Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.