Ajd Medical LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

AJD MEDICAL LLC

Doing business as

Antonio J Decarli, M.D.

Practice address

612 Palmetto St
New Smyrna Beach, FL 32168-7327

Phone

(386) 423-5500

Fax

(386) 409-9762

NPI assigned

Apr 8, 2009

Last updated

Aug 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Antontio J Decarli, M.D.

Title

President

Phone

(386) 423-5500

Specialties & licenses 1

Addresses

Other names 1

• Antonio J Decarli, M.D. Doing business as

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1386887230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687327",
            "telephone_number": "386-423-5500",
            "fax_number": "386-409-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687327",
            "telephone_number": "386-423-5500",
            "fax_number": "386-409-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJD MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "DECARLI",
        "authorized_official_first_name": "ANTONTIO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-423-5500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Antonio J Decarli, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.