PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC NPI 1619979580

NPI Information

NPI: 1619979580
Provider Name: PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC

Doing Business As: ADVENTHEALTH SURGERY CENTER PORT ORANGE

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1185 DUNLAWTON AVE STE 100
PORT ORANGE, FL
ZIP 32127
Phone: (386) 672-0017
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PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC is an ambulatory surgical clinic center in Port Orange, FL. PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC NPI is 1619979580. The provider is registered as an organization entity type.
The provider Is Doing Business As Adventhealth Surgery Center Port Orange.

The provider's business location address is:

1185 DUNLAWTON AVE STE 100
PORT ORANGE, FL
ZIP 32127-906
Phone: (386) 672-0017

The provider's authorized official is Brenda Alice Peters .
The authorized official title is Asc Administrator, Nursing Director and has the following contact phone number (386) 777-7151.

The CLIA number assigned to this NPI record is 10D2103376 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/11/2005 and was last updated on 1/3/2024.

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	1227	FLORIDA	Yes

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: 4/28/2024

NPI Synchronization or Removal

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