Healthcare Provider Details
I. General information
NPI: 1538940556
Provider Name (Legal Business Name): METRO ALLIANCE SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2023
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6201 ALLIANCE LN FL 2
FORT MYERS FL
33912-7164
US
IV. Provider business mailing address
1005 W INDIANTOWN RD STE 101
JUPITER FL
33458-6834
US
V. Phone/Fax
- Phone: 239-344-9786
- Fax:
- Phone: 561-630-6277
- Fax: 561-630-6062
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MOSES
K
SHIEH
Title or Position: MANAGER
Credential: M.D.
Phone: 239-344-9786