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General NPI Number Information
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NPI Number | 1154366060
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER OF NORTH FLORIDA, INC.
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 6520 NW 9TH BLVD
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City | GAINESVILLE
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State | FL
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Zip | 32605-4205
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Country | US
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Telephone | 352-331-7987
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Fax | 352-331-2787
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Provider Business Mailing Address
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Address Line | 6520 NW 9TH BLVD
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City | GAINESVILLE
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State | FL
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Zip | 32605-4205
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Country | US
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Telephone | 352-331-7987
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Fax | 352-331-2787
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ROGER THOMAS BRILL
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Credential | M.D.
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Telephone | 352-331-7987
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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 | ASC000252
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License Number State | FL
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