MEDICARE: ADVANCED SURGERY CENTER OF TALLAHASSEE, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207L00000X	Anesthesiology Physician
2	261QM1300X	Multi-Specialty Clinic/Center
3	261QS0132X	Ophthalmologic Surgery Clinic/Center
4	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1205658754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED SURGERY CENTER OF TALLAHASSEE, LLC

Provider Business Mailing Address
First Line	:	2535 CAPITAL MEDICAL BLVD STE 101
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4674
Country	:	US
Telephone Number	:	448-230-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	2535 CAPITAL MEDICAL BLVD STE 101
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4674
Country	:	US
Telephone Number	:	448-230-2311
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/CLINICAL DIRECTOR
Name	:	JOY WILLIAMS
Credential	:	RN
Telephone Number	:	448-230-2311

Provider Enumeration Date	:	10/28/2024
Last Update Date	:	04/30/2025

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