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General NPI Number Information
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NPI Number | 1891913547
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Entity Type | Organization
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Legal Business Name | PEMBROKE PINES AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17759 SW 2ND ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-3924
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Country | US
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Telephone | 954-436-0244
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Fax | 954-436-2471
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Provider Business Mailing Address
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Address Line | 17759 SW 2ND ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-3924
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Country | US
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Telephone | 954-436-0244
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Fax | 954-436-2471
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAY B. FINE
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Credential | M.D.
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Telephone | 954-436-0244
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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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