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General NPI Number Information
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NPI Number | 1679523351
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER OF PORT CHARLOTTE LTD
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 21260 OLEAN BLVD SUITE 105
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6705
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Country | US
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Telephone | 941-235-5800
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Fax | 941-235-5801
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Provider Business Mailing Address
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Address Line | 21260 OLEAN BLVD SUITE 105
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6705
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Country | US
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Telephone | 941-235-5800
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Fax | 941-235-5801
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Authorized Official
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Title or Position | VP
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Name | WILLIAM G SWINNEY
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Credential |
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Telephone | 972-789-2877
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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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