MEDICARE: VENTURE AMBULATORY SURGERY CENTER LLC

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
1	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083873277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VENTURE AMBULATORY SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	16853 NE 2ND AVE
Second Line	:	SUITE 400
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-1776
Country	:	US
Telephone Number	:	305-652-2999
Fax Number	:	305-652-8156

Provider Business Practice Location Address
First Line	:	16853 NE 2ND AVE
Second Line	:	SUITE 400
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-1776
Country	:	US
Telephone Number	:	305-652-2999
Fax Number	:	305-652-8156

Authorized Official
Title or Position	:	VP
Name	:	WILLIAM GREGORY SWINNEY
Credential	:
Telephone Number	:	972-789-2877

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	02/13/2018

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