MEDICARE: ORLANDO SURGERY CENTER II LTD

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	261QA1903X	FL

General Provider Information

NPI Number	:	1174526271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLANDO SURGERY CENTER II LTD

Provider Business Mailing Address
First Line	:	2000 N ORANGE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5533
Country	:	US
Telephone Number	:	407-897-2000
Fax Number	:	407-897-5192

Provider Business Practice Location Address
First Line	:	2000 N ORANGE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5533
Country	:	US
Telephone Number	:	407-897-2000
Fax Number	:	407-897-5192

Authorized Official
Title or Position	:	FACILITY ADMINISTRATOR
Name	:	MR. JEFF BRUENER
Credential	:
Telephone Number	:	407-897-2000

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	12/10/2007

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