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General NPI Number Information
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NPI Number | 1730118555
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Entity Type | Organization
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Legal Business Name | HARBORSIDE SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 08/17/2012
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Provider Practice Location Address
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Address Line | 610 E OLYMPIA AVE SUITE 100
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City | PUNTA GORDA
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State | FL
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Zip | 33950-3875
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Country | US
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Telephone | 941-637-0065
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Fax | 941-639-6545
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Provider Business Mailing Address
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Address Line | 610 E OLYMPIA AVE SUITE 100
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City | PUNTA GORDA
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State | FL
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Zip | 33950-3875
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Country | US
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Telephone | 941-637-0065
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Fax | 941-639-6545
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ARLINDA B DUNN
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Credential |
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Telephone | 941-833-1104
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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 | 10C0001220
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License Number State | FL
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