Healthcare Provider Details

I. General information

NPI: 1073759791
Provider Name (Legal Business Name): ALTMONTE OUTPATIENT SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2008
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 PALM SPRINGS DR
ALTAMONTE SPRINGS FL
32701-7841
US

IV. Provider business mailing address

652 PALM SPRINGS DR
ALTAMONTE SPRINGS FL
32701-7841
US

V. Phone/Fax

Practice location:
  • Phone: 321-303-9510
  • Fax: 321-303-9510
Mailing address:
  • Phone: 407-834-1800
  • Fax: 407-834-1840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. BELINDA STRATTON
Title or Position: ADMINISTRATOR
Credential:
Phone: 321-303-9510