1649273848 NPI number — NTC SURGERY CENTER, LTD.

Table of content: (NPI 1649273848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649273848 NPI number — NTC SURGERY CENTER, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NTC SURGERY CENTER, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649273848
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 OAKLEY SEAVER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLERMONT
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34711-1916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-536-1703
Provider Business Mailing Address Fax Number:
352-536-9057

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 OAKLEY SEAVER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLERMONT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34711-1916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-536-1703
Provider Business Practice Location Address Fax Number:
352-536-9057
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FLORIN
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
LUIS
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
352-536-1703

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  1206 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 106690-01 . This is a "CITRUS HLTHCARE-PROV.#" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 6G3 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2020137 . This is a "FIRST HEALTH -PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3640949 . This is a "AETNA HMO-PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5535681 . This is a "CCN NETWORK-PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 74780586 . This is a "AETNA PPO-PROVIDER #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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