Healthcare Provider Details

I. General information

NPI: 1801869847
Provider Name (Legal Business Name): AESCULAPIAN SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 CATTLEMEN RD SUITE 100
SARASOTA FL
34232-6056
US

IV. Provider business mailing address

3333 CATTLEMEN RD SUITE 100
SARASOTA FL
34232-6056
US

V. Phone/Fax

Practice location:
  • Phone: 941-379-5884
  • Fax: 941-379-1760
Mailing address:
  • Phone: 941-379-5884
  • Fax: 941-379-1760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number1181
License Number StateFL

VIII. Authorized Official

Name: MR. GEOFFREY G SIMON
Title or Position: CEO/ADMINISTRATOR
Credential: FACMPE
Phone: 941-955-1108