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Organization
EAST WEST LASER AND AMBULATORY SURGERY CENTER, LLC
Active
Organization
EAST WEST LASER AND AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL A. PECORARO M.D. (MANAGER)
(904) 272-2020
Entity
Organization
Contact information
Practice address
1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL 32003
(561) 630-6277
(561) 630-6062
Mailing address
1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL 32003
(561) 630-6277
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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