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General NPI Number Information
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NPI Number | 1417901018
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Entity Type | Organization
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Legal Business Name | TALLAHASSEE SINGLE DAY SURGERY LTD
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 1661 PHILLIPS RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5303
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Country | US
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Telephone | 850-878-5165
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Fax | 850-942-5545
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Provider Business Mailing Address
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Address Line | 1661 PHILLIPS RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5303
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Country | US
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Telephone | 850-878-5165
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Fax | 850-942-5545
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. AL E DEEB
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Credential | M.D.
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Telephone | 850-878-5165
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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 | 813
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License Number State | FL
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