Ajd Medical LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

82935 Issued in FL

Legal business name

AJD MEDICAL LLC

Practice address

1722 State Road 44
New Smyrna Beach, FL 32168-8339

Phone

(386) 427-0390

Fax

(386) 427-0394

NPI assigned

Dec 14, 2012

Last updated

Jan 23, 2021By 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

Antonio Decarli, M.D.NPI 1376644328

Title

Ceo

Phone

(386) 427-0390

Specialties & licenses 1

Addresses

Locations

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.

• Antonio Decarli, M.D.

  • Gastroenterology Physician
  • New Smyrna Beach, FL
  • NPI 1376644328
  Authorized official Same address or phone

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611360000000",
    "number": "1629314927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2616",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321702616",
            "telephone_number": "386-427-0390",
            "fax_number": "386-427-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 STATE ROAD 44",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688339",
            "telephone_number": "386-427-0390",
            "fax_number": "386-427-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJD MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A",
        "authorized_official_last_name": "DECARLI",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-427-0390",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "82935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saif Ahmed, M.D.
• Rajesh K Ailani, M.D.
• Ajd Medical Inc
• Ajd Medical Inc
• Ajd Medical LLC (Antonio J Decarli, M.D.)
• Akey Mobile Phlebotomy LLC
• Alba Court Development Group, LLC (Alba Court Adult Daycare)
• Jessica Albright, OTR/L
• Margaret M Aldridge
• Catherine Allbritton, DPT

• Gastroenterology Physician in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; 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.