MEDICARE: FLORIDA COSMETIC SURGERY CENTER

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	ME38085	FL

General Provider Information

NPI Number	:	1619380235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA COSMETIC SURGERY CENTER

Provider Business Mailing Address
First Line	:	201 MAITLAND AVE STE 1017
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4903
Country	:	US
Telephone Number	:	407-831-4454
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 MAITLAND AVE STE 1017
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4903
Country	:	US
Telephone Number	:	407-831-4454
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/MEDICAL DIRECTOR
Name	:	DR. DENNIS ROY WARD
Credential	:	M.D.
Telephone Number	:	407-831-4454

Provider Enumeration Date	:	06/11/2014
Last Update Date	:	06/11/2014

Similar Medicare Providers

1619961125 — DR. DENNIS ROY WARD M.D.
Practice Location Address:

201 MAITLAND AVE , SUITE 1017
ALTAMONTE SPRINGS, FL
32701-4903

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Practice Fax: 407-831-4559

1538328695 — DR. KIRK HENRY SOLBERG DMD
Practice Location Address:

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1396904389 — CHRISTOPHER PETER CHARD DMD
Practice Location Address:

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ALTAMONTE SPRINGS, FL
32701-4903

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Practice Fax:

1477712461 — MARCUS ORENE WILLIAMS III DMD
Practice Location Address:

201 MAITLAND AVE , 1013
ALTAMONTE SPRINGS, FL
32701-4903

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1407173883 — DR. CLAYTON JAMES MILLER D.D.S
Practice Location Address:

201 MAITLAND AVE , SUITE 1013
ALTAMONTE SPRINGS, FL
32701-4903

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1104160092 — DENNIS R. WARD, MD PA
Practice Location Address:

201 MAITLAND AVE , SUITE 1017
ALTAMONTE SPRINGS, FL
32701-4903

Practice Phone: 407-831-4454
Practice Fax: 407-831-4559

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