EAST WEST LASER AND AMBULATORY SURGERY CENTER LLC NPI 1225701824

NPI Information

NPI: 1225701824
Provider Name: EAST WEST LASER AND AMBULATORY SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D2261854

Address:
1855 EAST-WEST PARKWAY
SUITE 1
FLEMING ISLAND, FL
ZIP 32003
Phone: (561) 630-6277
Get Directions

EAST WEST LASER AND AMBULATORY SURGERY CENTER, LLC is an ambulatory surgical clinic center in Fleming Island, FL. EAST WEST LASER AND AMBULATORY SURGERY CENTER, LLC NPI is 1225701824. The provider is registered as an organization entity type.

The provider's business location address is:

1855 EAST-WEST PARKWAY
SUITE 1
FLEMING ISLAND, FL
ZIP 32003
Phone: (561) 630-6277
Fax: (561) 630-6062

The provider's authorized official is Russell A. Pecoraro .
The authorized official title is Manager and has the following contact phone number (904) 272-2020.

The CLIA number assigned to this NPI record is 10D2261854 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2021 and was last updated on 7/29/2021.

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

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »