FLEMING ISLAND SURGERY CENTER NPI 1457428005

NPI Information

NPI: 1457428005
Provider Name: FLEMING ISLAND SURGERY CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D1063710

Address:
1670 EAGLE HARBOR PKWY
SUITE B
ORANGE PARK, FL
ZIP 32003
Phone: (904) 541-3048
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FLEMING ISLAND SURGERY CENTER is an ambulatory surgical clinic center in Orange Park, FL. FLEMING ISLAND SURGERY CENTER NPI is 1457428005. The provider is registered as an organization entity type.

The provider's business location address is:

1670 EAGLE HARBOR PKWY
SUITE B
ORANGE PARK, FL
ZIP 32003-806
Phone: (904) 541-3048
Fax: (904) 215-7960

The provider's authorized official is Tara Shea Mclaughlin .
The authorized official title is Director Of Contracting and has the following contact phone number (727) 785-9800.

The CLIA number assigned to this NPI record is 10D1063710 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	PENDING	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PENDING	OTHER	FLORIDA	STATE LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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