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NPI Code Detail

MEDICARE: SURGICARE CENTER LLC

MEDICARE: SURGICARE CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/CenterPH10568FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110C0001029OTHERCCN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598846925
Entity Type Code : Organization
Provider Name (Legal Business Name) : SURGICARE CENTER LLC
Provider Business Mailing Address
First Line : PO BOX 11407
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35246-8575
Country : US
Telephone Number : 864-359-1308
Fax Number :
Provider Business Practice Location Address
First Line : 4101 EVANS AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9310
Country : US
Telephone Number : 239-939-3456
Fax Number : 239-790-2432
Authorized Official
Title or Position : CFO
Name : KEVIN BECKER
Credential :
Telephone Number : 470-243-2259
Provider Enumeration Date : 10/19/2006
Last Update Date : 04/10/2026

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Directions to “SURGICARE CENTER LLC ” Practice Location

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