Healthcare Provider Details

I. General information

NPI: 1285955799
Provider Name (Legal Business Name): NATURE COAST SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N BYRON BUTLER PKWY
PERRY FL
32347-2315
US

IV. Provider business mailing address

2100 SE OCEAN BLVD SUITE 102
STUART FL
34996-3332
US

V. Phone/Fax

Practice location:
  • Phone: 850-584-2778
  • Fax: 850-584-2790
Mailing address:
  • Phone: 772-223-9130
  • Fax: 772-223-9120

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 O BARATTA
Title or Position: CEO
Credential: M.D.
Phone: 772-223-9130