Healthcare Provider Details

I. General information

NPI: 1710501879
Provider Name (Legal Business Name): HZ SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17085 PORTER ROAD SUITE 110
WINTER GARDEN FL
34787
US

IV. Provider business mailing address

7575 DR PHILLIPS BLVD STE 10
ORLANDO FL
32819-7221
US

V. Phone/Fax

Practice location:
  • Phone: 239-784-8266
  • Fax:
Mailing address:
  • Phone: 407-377-5438
  • Fax: 407-386-6188

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: MR. GARY PATRICK MUZZONIGRO JR.
Title or Position: CEO
Credential:
Phone: 239-784-8266