Amerinet Health Center South Daytona, LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

OS5974 Issued in FL

Legal business name

AMERINET HEALTH CENTER SOUTH DAYTONA, LLC

Practice address

619 Beville Rd
South Daytona, FL 32119-1935

Phone

(702) 287-8602

NPI assigned

Jan 3, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Bryan Preston Caudill

Title

Partner

Phone

(702) 287-8602

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1326342585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 BEVILLE RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 BEVILLE RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191935",
            "telephone_number": "702-287-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERINET HEALTH CENTER SOUTH DAYTONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "CAUDILL",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "PRESTON",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "702-287-8602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "OS5974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.