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General NPI Number Information
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NPI Number | 1205718061
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Entity Type | Organization
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Legal Business Name | FLORIDA ST. BARBARA'S SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1745 HERITAGE TRL
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City | NAPLES
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State | FL
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Zip | 34112-7591
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Country | US
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Telephone | 239-799-1797
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Fax |
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Provider Business Mailing Address
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Address Line | 332 SHORELINE DR
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City | NACOGDOCHES
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State | TX
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Zip | 75964-8023
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | ARJUN GANGAKHEDKAR
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Credential |
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Telephone | 646-902-5164
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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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