MEDICARE: PHYSICIANS DAY 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	1065	FL

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	:	1386647402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS DAY SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	850 111TH AVE N
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34108-1803
Country	:	US
Telephone Number	:	239-596-2557
Fax Number	:	239-596-2563

Provider Business Practice Location Address
First Line	:	850 111TH AVE N
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34108-1803
Country	:	US
Telephone Number	:	239-596-2557
Fax Number	:	239-596-2563

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	ROBIN DIONNE WRIGHT
Credential	:
Telephone Number	:	239-596-2557

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/30/2024

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