Healthcare Provider Details

I. General information

NPI: 1750364634
Provider Name (Legal Business Name): BETHESDA OUTPATIENT SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 09/20/2025
Certification Date: 09/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 S DIXIE HIGHWAY SUITE 101
WEST PALM BEACH FL
33405-3724
US

IV. Provider business mailing address

PO BOX 628762
ORLANDO FL
32862-8762
US

V. Phone/Fax

Practice location:
  • Phone: 561-374-5550
  • Fax: 561-374-9977
Mailing address:
  • Phone: 813-549-2134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number935
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: TRACIE GARI
Title or Position: CHIEF ADMININISTRATIVE OFFICER
Credential:
Phone: 813-549-2134