Healthcare Provider Details

I. General information

NPI: 1598846925
Provider Name (Legal Business Name): SURGICARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 EVANS AVE
FORT MYERS FL
33901-9310
US

IV. Provider business mailing address

PO BOX 11407
BIRMINGHAM AL
35246-8575
US

V. Phone/Fax

Practice location:
  • Phone: 239-939-3456
  • Fax: 239-790-2432
Mailing address:
  • Phone: 864-359-1308
  • Fax: 239-496-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberPH10568
License Number StateFL

VIII. Authorized Official

Name: KEVIN BECKER
Title or Position: CFO
Credential:
Phone: 470-243-2259