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NPI Code Detail

MEDICARE: PHYSICIANS AMBULATORY SURGERY CENTER INC

MEDICARE: PHYSICIANS AMBULATORY SURGERY CENTER INC
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/Center886FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669483137
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIANS AMBULATORY SURGERY CENTER INC
Provider Business Mailing Address
First Line : 300 CLYDE MORRIS BLVD
Second Line : SUITE B
City : ORMOND BEACH
State : FL
Zip : 32174-5956
Country : US
Telephone Number : 386-672-1080
Fax Number : 386-672-8628
Provider Business Practice Location Address
First Line : 300 CLYDE MORRIS BLVD
Second Line : SUITE B
City : ORMOND BEACH
State : FL
Zip : 32174-5956
Country : US
Telephone Number : 386-672-1080
Fax Number : 386-672-8628
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. ELIZABETH LEE BAYLOR
Credential :
Telephone Number : 386-672-1080
Provider Enumeration Date : 08/10/2006
Last Update Date : 02/19/2009

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Directions to “PHYSICIANS AMBULATORY SURGERY CENTER INC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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