Ips of Deltona LLC

NPI #1912148636 in Deltona, Florida

Provider Information

NPI Number: 1912148636
Entity Type: Organization
Organization Name: Ips of Deltona LLC
Primary Specialty: Anesthesiology
Enumeration Date: Mar 9, 2009
Last Updated: Mar 9, 2009

Practice Location

Address: 777 DELTONA BLVD
Address 2: SUITE 21
City: Deltona
State: Florida
ZIP Code: 32725-7173
Phone: (386) 575-2225

Authorized Official

Name: CARL RICHARDSON NOBACK, MD
Title: PRESIDENT
Phone: (941) 360-1566

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X
Nurse Anesthetist, Certified Registered	367500000X
Anesthesiology	207L00000X	Primary

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