PONTE VEDRA AMBULATORY SURGERY CENTER LLC NPI 1760591952

NPI Information

NPI: 1760591952
Provider Name: PONTE VEDRA AMBULATORY SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D2216567

Address:
209 PONTE VEDRA PARK DRIVE
PONTE VEDRA BEACH, FL
ZIP 32082
Phone: (904) 273-6200
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PONTE VEDRA AMBULATORY SURGERY CENTER, LLC is an ambulatory surgical clinic center in Ponte Vedra Beach, FL. PONTE VEDRA AMBULATORY SURGERY CENTER, LLC NPI is 1760591952. The provider is registered as an organization entity type.

The provider's business location address is:

209 PONTE VEDRA PARK DRIVE
PONTE VEDRA BEACH, FL
ZIP 32082-600
Phone: (904) 273-6200
Fax: (904) 280-8013

The provider's authorized official is Robin Solomon .
The authorized official title is Managing Employee and has the following contact phone number (904) 273-6200.

The CLIA number assigned to this NPI record is 10D2216567 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 4/25/2024.

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	1156	FLORIDA	No
2	261QA1903X	Clinic/Center	Ambulatory Surgical	10-C001394	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: 5/5/2024

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