INTRACOASTAL SURGERY CENTER LLC NPI 1326527680

NPI Information

NPI: 1326527680
Provider Name: INTRACOASTAL SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D2153558

Address:
2200 W EAU GALLIE BLVD STE 100
MELBOURNE, FL
ZIP 32935
Phone: (321) 795-6095
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INTRACOASTAL SURGERY CENTER, LLC is an ambulatory surgical clinic center in Melbourne, FL. INTRACOASTAL SURGERY CENTER, LLC NPI is 1326527680. The provider is registered as an organization entity type.

The provider's business location address is:

2200 W EAU GALLIE BLVD STE 100
MELBOURNE, FL
ZIP 32935-166
Phone: (321) 795-6095

The provider's authorized official is John Wheeler .
The authorized official title is Clinical Administrator and has the following contact phone number (321) 610-3460.

The CLIA number assigned to this NPI record is 10D2153558 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/8/2018 and was last updated on 3/20/2019.

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

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