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General NPI Number Information
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NPI Number | 1679662001
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Entity Type | Organization
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Legal Business Name | WEBSTER SURGICAL CENTER OF TALLAHASSEE LLC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 2048 CENTRE POINTE LN
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4300
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Country | US
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Telephone | 850-878-0471
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Fax | 850-942-5733
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Provider Business Mailing Address
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Address Line | 2048 CENTRE POINTE LN
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4300
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Country | US
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Telephone | 850-878-0471
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Fax | 850-942-5733
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Authorized Official
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Title or Position | COO
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Name | MR. THADDEUS J HILL
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Credential |
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Telephone | 850-878-0471
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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 | 1140
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License Number State | FL
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