Ajd Medical LLC

Organization Active NPI Specialist · New Smyrna Beach, FL

NPI 1386887230 · NPPES record last updated Aug 12, 2010

Key facts

NPI
1386887230
Entity type
Organization (NPI type 2)
Primary specialty
Specialist 174400000X
Legal business name
AJD MEDICAL LLC
Practice address
612 Palmetto St
New Smyrna Beach, FL 32168-7327
Phone
(386) 423-5500
Fax
(386) 409-9762
NPI assigned
Apr 8, 2009
Organization subpart
No

Authorized official

Name
Antontio J Decarli, M.D.
Title
President
Phone
(386) 423-5500

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist
Group: 193400000X SINGLE SPECIALTY GROUP
174400000X Yes

Addresses

Primary practice location

612 Palmetto St
New Smyrna Beach, FL 32168-7327

Mailing address

612 Palmetto St
New Smyrna Beach, FL 32168-7327
Phone (386) 423-5500

Other identifiers

IdentifierTypeStateIssuer
000749600MedicaidFL

Other names

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

Other providers in New Smyrna Beach, FL

All providers in New Smyrna Beach, FL · Specialist in Florida

Sources for this page

Verify at the official NPI Registry.