Healthcare Provider Details

I. General information

NPI: 1215097845
Provider Name (Legal Business Name): NEWGATE SURGERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 02/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 TAMIAMI TRL N SUITE 202
NAPLES FL
34103-2817
US

IV. Provider business mailing address

5200 TAMIAMI TRL N SUITE 202
NAPLES FL
34103-2817
US

V. Phone/Fax

Practice location:
  • Phone: 239-263-6766
  • Fax: 239-263-3320
Mailing address:
  • Phone: 239-263-6766
  • Fax: 239-263-3320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number843
License Number StateFL

VIII. Authorized Official

Name: REBECCA L CRANE
Title or Position: OWNER
Credential: M.D.
Phone: 239-263-6766