Healthcare Provider Details

I. General information

NPI: 1477070340
Provider Name (Legal Business Name): BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 05/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 CLINT MOORE RD STE 115
BOCA RATON FL
33496-2659
US

IV. Provider business mailing address

6855 RED ROAD
CORAL GABLES FL
33143-3632
US

V. Phone/Fax

Practice location:
  • Phone: 561-509-5084
  • Fax:
Mailing address:
  • Phone: 786-662-7980
  • Fax: 786-533-9403

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: MS. PATRICIA ROSELLO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 786-662-7111