Mja Healthcare of Florida, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD424898 Issued in PA

Legal business name

MJA HEALTHCARE OF FLORIDA, PC

Practice address

912 S. Ridgewood Avenue
Suite D
Daytona Beach, FL 32114

Phone

(570) 872-9800

Fax

(570) 872-9888

NPI assigned

Nov 22, 2013

Organization subpart

No

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

Authorized official

Name

Mikhail Artamonov, MD

Title

Owner

Phone

(570) 241-9224

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1407286727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183019101",
            "telephone_number": "570-241-9224",
            "fax_number": "570-872-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S. RIDGEWOOD AVENUE",
            "address_2": "SUITE D",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "570-872-9800",
            "fax_number": "570-872-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJA HEALTHCARE OF FLORIDA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "ARTAMONOV",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-241-9224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD424898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.