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General NPI Number Information
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NPI Number | 1043605934
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Entity Type | Organization
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Legal Business Name | SEASIDE SURGERY CENTER, LLC
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 1879 VETERANS PARK DR
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City | NAPLES
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State | FL
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Zip | 34109-0500
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Country | US
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Telephone | 239-248-7623
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Fax |
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Provider Business Mailing Address
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Address Line | 1879 VETERANS PARK DR STE 1101
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City | NAPLES
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State | FL
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Zip | 34109-0500
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Country | US
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Telephone | 239-592-4955
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Fax |
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Authorized Official
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Title or Position | OFFICER/AUTHORIZED OFFICIAL
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Name | COLLIN LEMAISTRE
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Credential |
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Telephone | 404-781-2921
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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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