# MENTOR SURGERY CENTER LTD

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

## Provider details

- **NPI number:** 1417958729
- **Authorized official:** MISS TRACY ANN PETERS CPC (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (440) 205-5467

## Contact information

- **Practice address:** 9485 MENTOR AVE, STE 1, MENTOR, OH 44060-4597
- **Practice address phone:** (440) 205-5454
- **Practice address fax:** (440) 205-5402
- **Mailing address:** 9485 MENTOR AVE, STE 1, MENTOR, OH 44060-8711
- **Mailing address phone:** (440) 205-5454
- **Mailing address fax:** (440) 205-5402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0404AS | OH | Yes |

## Other

- **Enumeration date:** 08/09/2005
- **Last updated:** 12/31/2014