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General NPI Number Information
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NPI Number | 1215924899
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Entity Type | Organization
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Legal Business Name | ATLANTIC SURGICAL CENTER, INC.
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 150 SW 12TH AVE SUITE 201
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-946-3603
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Fax | 954-781-2144
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Provider Business Mailing Address
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Address Line | 150 SW 12TH AVE SUITE 450
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-946-3603
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Fax | 954-781-2144
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Authorized Official
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Title or Position | CEO
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Name | MR. JOHN W. BEEBE
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Credential |
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Telephone | 954-946-3603
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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 | 1015
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License Number State | FL
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