Lake Mary Surgery Center LLC
Clinic/Center, Ambulatory Surgical in Lake Mary, FL. Organization (NPI-2).
NPI number1174530752
StatusActive
Last updated in NPPESFeb 21, 2023
Details
- NPI
- 1174530752
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake Mary Surgery Center LLC
- Organization subpart
- No
- Enumeration date
- Aug 3, 2006
- Certification date
- Feb 21, 2023
- Last updated
- Feb 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | 1204 | FL | Yes |
Practice location
460 Saint Charles CtLake Mary, FL 32746-2103
Phone 407-585-0260 · Fax 407-585-0264
Mailing address
460 Saint Charles CtLake Mary, FL 32746-2103
Phone 407-585-0260 · Fax 407-585-0264
Authorized official
Jennifer Boyd Baldock
Officer And Authorized Official
6152345954
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