RIVERSIDE SURGERY CENTER INC NPI 1700876703

NPI Information

NPI: 1700876703
Provider Name: RIVERSIDE SURGERY CENTER INC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D2108638

Address:
14410 US HIGHWAY 1
SEBASTIAN, FL
ZIP 32958
Phone: (772) 589-8111
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RIVERSIDE SURGERY CENTER INC is an ambulatory surgical clinic center in Sebastian, FL. RIVERSIDE SURGERY CENTER INC NPI is 1700876703. The provider is registered as an organization entity type.

The provider's business location address is:

14410 US HIGHWAY 1
SEBASTIAN, FL
ZIP 32958-237
Phone: (772) 589-8111
Fax: (772) 589-7561

The provider's authorized official is Trish A Daniels .
The authorized official title is Administrator and has the following contact phone number (772) 589-8111.

The CLIA number assigned to this NPI record is 10D2108638 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/21/2005 and was last updated on 12/4/2012.

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	1034	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	490005283	OTHER	FLORIDA	RAIL ROAD MEDICARE
2	5863630001	MEDICARE NSC	FLORIDA
3	F1268	OTHER	FLORIDA	MEDICARE PTAN
4	001577500	MEDICAID	FLORIDA
5	0499360	OTHER	FLORIDA	GHI FACILITY NUMBER
6	67R	OTHER	FLORIDA	BCBS FACILITY 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: 4/28/2024

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