NPIMap

Organization Active NPI

Hand & Upper Extremity Surgery of Daytona Beach, LLC

  • Non-Pharmacy Dispensing Site
  • Daytona Beach, FL
National Provider Identifier
1346752755
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
OS9696 Issued in FL
Legal business name
HAND & UPPER EXTREMITY SURGERY OF DAYTONA BEACH, LLC
Doing business as
Hand & Upper Extremity Surgery of Daytona Beach, LLC
Practice address
1241 Ridgewood Ave
Daytona Beach, FL 32114
Phone
(479) 636-9702
Fax
(877) 427-2307
NPI assigned
Oct 26, 2017
Last updated
Oct 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Authorized official

Name
Mrs. Amanda Gonzalezz
Title
Ncpdp Coordinator
Phone
(479) 636-9702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X OS9696 FL Primary

Addresses

Primary practice location

1241 Ridgewood Ave
Daytona Beach, FL 32114

Mailing address

PO Box 1784
Bentonville, AR 72712
Phone (479) 636-9702

Other names 1

  • Hand & Upper Extremity Surgery of Daytona Beach, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hand Upper Extremity Surg of Daytona B2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1346752755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1784",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-636-9702",
            "fax_number": "877-427-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 RIDGEWOOD AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "479-636-9702",
            "fax_number": "877-427-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAND & UPPER EXTREMITY SURGERY OF DAYTONA BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "GONZALEZZ",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "NCPDP COORDINATOR",
        "authorized_official_telephone_number": "479-636-9702",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "OS9696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hand & Upper Extremity Surgery of Daytona Beach, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.