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General NPI Number Information
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NPI Number | 1659535367
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA SURGERY CENTER INC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 256 SW PROFESSIONAL GLN
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City | LAKE CITY
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State | FL
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Zip | 32025-1104
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Country | US
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Telephone | 386-758-8937
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Fax | 386-755-2169
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Provider Business Mailing Address
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Address Line | 256 SW PROFESSIONAL GLN
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City | LAKE CITY
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State | FL
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Zip | 32025-1104
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Country | US
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Telephone | 386-758-8937
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Fax | 386-755-2169
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD REICHERT
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Credential | M.D.
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Telephone | 386-758-8937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME70187
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License Number State | FL
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