Space Coast Surgery Center LLC
NPI #1164662912 in Merritt Island, Florida
Provider Information
- NPI Number
- 1164662912
- Entity Type
- Organization
- Organization Name
- Space Coast Surgery Center LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Mar 5, 2009
- Last Updated
- Nov 1, 2022
Practice Location
- Address
- 595 N COURTENAY PKWY
- Address 2
- 103
- City
- Merritt Island
- State
- Florida
- ZIP Code
- 32953-4851
- Phone
- (813) 569-6500
Authorized Official
- Name
- JENNIFER B BALDOCK
- Title
- OFFICER AND AUTHORIZED OFFICIAL
- Phone
- (615) 234-5954
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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