Healthcare Provider Details

I. General information

NPI: 1225517279
Provider Name (Legal Business Name): ORLANDO OUTPATIENT SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 33RD ST
ORLANDO FL
32839
US

IV. Provider business mailing address

PO BOX 628772
ORLANDO FL
32862-8772
US

V. Phone/Fax

Practice location:
  • Phone: 407-385-1555
  • Fax:
Mailing address:
  • Phone: 407-385-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA HELMS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 813-549-2134