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NPI Code Detail

MEDICARE: FLORIDA COASTAL SURGERY CENTER, INC

MEDICARE: FLORIDA COASTAL SURGERY CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center1067FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1313355OTHERFLUHC
267YOTHERFLBCBS

General Provider Information

NPI Number : 1003812686
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA COASTAL SURGERY CENTER, INC
Provider Business Mailing Address
First Line : 801 ANCHOR RODE DRIVE
Second Line : SUITE 100
City : NAPLES
State : FL
Zip : 34103-2742
Country : US
Telephone Number : 239-263-1717
Fax Number : 239-403-9410
Provider Business Practice Location Address
First Line : 801 ANCHOR RODE DRIVE
Second Line : SUITE 100
City : NAPLES
State : FL
Zip : 34103-2742
Country : US
Telephone Number : 239-263-1717
Fax Number : 239-403-9410
Authorized Official
Title or Position : BILLING MANAGER
Name : MS. NICOLE M. BABB
Credential :
Telephone Number : 239-263-1717
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/21/2022

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