Provider Demographics
NPI:1053550749
Name:ACCDIENT & INJURY CENTER INC
Entity type:Organization
Organization Name:ACCDIENT & INJURY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:VASSILAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-668-9622
Mailing Address - Street 1:807 BEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-1824
Mailing Address - Country:US
Mailing Address - Phone:386-668-9622
Mailing Address - Fax:
Practice Address - Street 1:807 BEVILLE RD
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1824
Practice Address - Country:US
Practice Address - Phone:386-668-9622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8852261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty