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Organization
ST NICHOLAS AMBULATORY SURGICAL CENTER PA
Active
Organization
ST NICHOLAS AMBULATORY SURGICAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENE U PULIDO MD (PRESIDENT)
(904) 647-8576
Entity
Organization
Contact information
Practice address
2570 ATLANTIC BLVD, JACKSONVILLE, FL 32207-3604
(904) 647-8576
(904) 253-3098
Mailing address
2624 ATLANTIC BLVD, JACKSONVILLE, FL 32207-3668
(904) 647-8576
(904) 253-3098
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/11/2013
Last updated
11/11/2013
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