SURGICAL SPECIALISTS ASC LLC NPI 1780871319

NPI Information

NPI: 1780871319
Provider Name: SURGICAL SPECIALISTS ASC, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D1084859

Address:
1034 MAR WALT DR STE 300
FORT WALTON BEACH, FL
ZIP 32547
Phone: (850) 315-9385
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SURGICAL SPECIALISTS ASC, LLC is an ambulatory surgical clinic center in Fort Walton Beach, FL. SURGICAL SPECIALISTS ASC, LLC NPI is 1780871319. The provider is registered as an organization entity type.

The provider's business location address is:

1034 MAR WALT DR STE 300
FORT WALTON BEACH, FL
ZIP 32547-645
Phone: (850) 315-9385
Fax: (850) 315-9350

The provider's authorized official is Suzette K Gramm .
The authorized official title is Administrator and has the following contact phone number (850) 315-9206.

The CLIA number assigned to this NPI record is 10D1084859 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/27/2007 and was last updated on 9/5/2008.

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			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	F1515	MEDICARE PIN	FLORIDA

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

NPI Synchronization or Removal

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