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General NPI Number Information
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NPI Number | 1346969789
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Entity Type | Organization
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Legal Business Name | ADVENTHEALTH SURGERY CENTER INNOVATION TOWER, LLC
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 265 E. ROLLINS STREET 4TH FLOOR SUITE 4500
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City | ORLANDO
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State | FL
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Zip | 32804
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Country | US
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Telephone | 407-200-3706
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Fax |
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Provider Business Mailing Address
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Address Line | 265 E. ROLLINS STREET 4TH FLOOR SUITE 4500
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City | ORLANDO
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State | FL
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Zip | 32804
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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 | EXECUTIVE DIRECTOR
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Name | PATTY SHOULTS
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Credential | MBA, BSN, RN CNOR, C
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Telephone | 407-200-3706
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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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