Healthcare Provider Details

I. General information

NPI: 1235393356
Provider Name (Legal Business Name): PHYSICIANS OUTPATIENT SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NE 56TH ST
FT LAUDERDALE FL
33334-4149
US

IV. Provider business mailing address

1000 NE 56TH ST
FT LAUDERDALE FL
33334-4149
US

V. Phone/Fax

Practice location:
  • Phone: 954-958-0635
  • Fax: 954-489-2846
Mailing address:
  • Phone: 954-958-0635
  • Fax: 954-489-2846

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: ROBERT CASALOU
Title or Position: PRESIDENT & CEO
Credential:
Phone: 734-712-3792