Healthcare Provider Details

I. General information

NPI: 1326003187
Provider Name (Legal Business Name): SURGICAL CENTER ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S ORLANDO AVE
WINTER PARK FL
32789-4851
US

IV. Provider business mailing address

1000 S ORLANDO AVE
WINTER PARK FL
32789-4851
US

V. Phone/Fax

Practice location:
  • Phone: 407-629-1500
  • Fax: 407-629-1741
Mailing address:
  • Phone: 407-629-1500
  • Fax: 407-629-1741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number1018
License Number StateFL

VIII. Authorized Official

Name: MRS. TONI MASSING
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 407-629-1500