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NPI Code Detail

MEDICARE: SURGERY CENTER OF PORT CHARLOTTE LTD

MEDICARE: SURGERY CENTER OF PORT CHARLOTTE LTD
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/Center

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 : 1679523351
Entity Type Code : Organization
Provider Name (Legal Business Name) : SURGERY CENTER OF PORT CHARLOTTE LTD
Provider Business Mailing Address
First Line : 21260 OLEAN BLVD
Second Line : SUITE 105
City : PORT CHARLOTTE
State : FL
Zip : 33952-6705
Country : US
Telephone Number : 941-235-5800
Fax Number : 941-235-5801
Provider Business Practice Location Address
First Line : 21260 OLEAN BLVD
Second Line : SUITE 105
City : PORT CHARLOTTE
State : FL
Zip : 33952-6705
Country : US
Telephone Number : 941-235-5800
Fax Number : 941-235-5801
Authorized Official
Title or Position : VP
Name : WILLIAM G SWINNEY
Credential :
Telephone Number : 972-789-2877
Provider Enumeration Date : 05/11/2006
Last Update Date : 02/06/2018

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Directions to “SURGERY CENTER OF PORT CHARLOTTE LTD ” Practice Location

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