Healthcare Provider Details

I. General information

NPI: 1568800829
Provider Name (Legal Business Name): GLOBAL MICROSURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2013
Last Update Date: 04/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2712 REW CIR
OCOEE FL
34761-2990
US

IV. Provider business mailing address

2712 REW CIR
OCOEE FL
34761-2990
US

V. Phone/Fax

Practice location:
  • Phone: 407-649-8585
  • Fax: 407-386-7045
Mailing address:
  • Phone: 630-632-8119
  • Fax: 407-386-7045

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: DR. ROBERT L MASSON
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 630-632-8119