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General NPI Number Information
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NPI Number | 1326047101
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Entity Type | Organization
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Legal Business Name | ST. LUCY'S OUTPATIENT SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 21275 OLEAN BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6704
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Country | US
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Telephone | 941-625-1325
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Fax | 941-625-0131
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Provider Business Mailing Address
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Address Line | PO BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35246-8575
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Country | US
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Telephone | 941-625-1325
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Fax | 941-625-0131
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JOHN SWENCKI
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Credential |
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Telephone | 941-213-1447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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