Healthcare Provider Details

I. General information

NPI: 1912018086
Provider Name (Legal Business Name): CENTER FOR ENDOSCOPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 S TAMIAMI TRAIL SUITE 100
SARASOTA FL
34239
US

IV. Provider business mailing address

3325 S TAMIAMI TRAIL SUITE 100
SARASOTA FL
34239
US

V. Phone/Fax

Practice location:
  • Phone: 941-552-3480
  • Fax: 941-552-3485
Mailing address:
  • Phone: 941-552-3480
  • Fax: 941-552-3485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number1164
License Number StateFL

VIII. Authorized Official

Name: DR. CHARLES LOEWE
Title or Position: PRESIDENT
Credential: MD
Phone: 941-552-3480