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General NPI Number Information
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NPI Number | 1912610882
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Entity Type | Organization
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Legal Business Name | ADVANCED SURGERY CENTER OF FORT MYERS LLC
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 12460 BRANTLEY COMMONS CT
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City | FORT MYERS
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State | FL
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Zip | 33907-5685
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Country | US
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Telephone | 239-236-8933
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Fax |
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Provider Business Mailing Address
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Address Line | 12468 BRANTLEY COMMONS CT
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City | FORT MYERS
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State | FL
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Zip | 33907-5663
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Country | US
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Telephone | 239-689-5327
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Fax | 239-992-1723
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RHONDA CAMRON
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Credential | DNP, RN, CRT, CLNC
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Telephone | 407-698-4616
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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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