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General NPI Number Information
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NPI Number | 1518373695
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Entity Type | Organization
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Legal Business Name | HOLLYWOOD SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 1201 N 35TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33021
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Country | US
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Telephone | 321-403-3991
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Fax | 321-978-0272
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Provider Business Mailing Address
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Address Line | 1062 JANS PL
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City | MELBOURNE
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State | FL
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Zip | 32940-6972
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Country | US
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Telephone | 321-403-3991
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Fax | 321-978-0272
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Authorized Official
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Title or Position | VICE MANAGER
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Name | MR. BOAZ BAR-NAVON
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Credential |
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Telephone | 321-403-3991
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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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