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General NPI Number Information
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NPI Number | 1295155182
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Entity Type | Organization
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Legal Business Name | CITRUS ENDOSCOPY AND SURGERY
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Dates
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Enumeration Date | 04/18/2014
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Last Update Date | 04/18/2014
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Provider Practice Location Address
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Address Line | 6410 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-7622
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Country | US
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Telephone | 352-563-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 6410 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429
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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 | BILLING CLERK
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Name | MRS. LISA M HUGHES
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Credential |
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Telephone | 352-795-6113
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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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