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General NPI Number Information
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NPI Number | 1043290653
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Entity Type | Organization
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Legal Business Name | SUNCOAST SURGERY CENTER, LLC
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 9617 GULF RESEARCH LN
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City | FORT MYERS
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State | FL
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Zip | 33912-4555
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Country | US
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Telephone | 239-791-2273
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Fax | 239-790-0375
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Provider Business Mailing Address
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Address Line | 9617 GULF RESEARCH LN
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City | FORT MYERS
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State | FL
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Zip | 33912-4555
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Country | US
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Telephone | 239-418-0999
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Fax | 239-418-0991
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Authorized Official
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Title or Position | CREDENTIALING SPECIALISTS
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Name | PAM S. MARRERO
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Credential |
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Telephone | 239-215-6884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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