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General NPI Number Information
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NPI Number | 1639237183
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Entity Type | Organization
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Legal Business Name | ADVANCED SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/31/2017
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Provider Practice Location Address
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Address Line | 201 N PINE ISLAND RD
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City | PLANTATION
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State | FL
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Zip | 33324-1840
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Country | US
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Telephone | 954-358-1260
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Fax | 954-320-4181
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Provider Business Mailing Address
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Address Line | 201 N. PINE ISLAND RD.
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City | PLANTATION
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State | FL
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Zip | 33324
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Country | US
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Telephone | 954-358-1260
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Fax | 954-358-1261
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICK ABAE
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Credential | MD
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Telephone | 954-587-2273
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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 | 108032
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License Number State | FL
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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 | 1234
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License Number State | FL
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