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General NPI Number Information
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NPI Number | 1831420694
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Entity Type | Organization
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Legal Business Name | TITUSVILLE CENTER FOR SURGICAL EXCELLENCE LLC
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 814 S WASHINGTON AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-2406
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Country | US
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Telephone | 321-567-6300
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Fax | 321-567-6320
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Provider Business Mailing Address
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Address Line | 814 S WASHINGTON AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-2406
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Country | US
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Telephone | 321-567-6300
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Fax | 321-567-6320
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | COLLIN LEMAISTRE
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Credential |
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Telephone | 214-213-0732
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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 | 1333
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License Number State | FL
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