# OAKRIDGE AMBULATORY SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285788505
- **Authorized official:** MR. FRITZ PHANORD (MANAGER BUSINESS OFFICE)
- **Authorized official phone:** (954) 958-0606

## Contact information

- **Practice address:** 1000 NE 56TH ST, ATTN BUSINESS OFFICE, FORT LAUDERDALE, FL 33334-4149
- **Practice address phone:** (954) 958-0606
- **Practice address fax:** (354) 776-0821
- **Mailing address:** 1000 NE 56TH ST, ATTN BUSINESS OFFICE, FORT LAUDERDALE, FL 33334-4149
- **Mailing address phone:** (954) 958-0606
- **Mailing address fax:** (354) 776-0821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1081 | FL | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 214922 | AMERIGROUP PROVIDER ID | FL |
| 01 | — | 278619 | AVMED PROVIDER ID | FL |
| 01 | — | 5461696 | AETNA HLTHCR ID | FL |
| 01 | — | 67P | BC BS PROVIDER ID | FL |
| 01 | — | 8329702001 | CIGNA HLTHCR ID | FL |
| 01 | — | 836 | TOTAL HLTH CHOICE ID | FL |
| 01 | — | SG013536 | VISTA HLTHCR ID | FL |