# WINTER HAVEN AMBULATORY SURGICAL CENTER LLC

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

## Provider details

- **NPI number:** 1538126362
- **Authorized official:** COLLIN LEMAISTRE (OFFICER/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (469) 250-3640

## Contact information

- **Practice address:** 325 AVE B NW, WINTER HAVEN, FL 33881
- **Practice address phone:** (863) 291-4000
- **Practice address fax:** (863) 299-9179
- **Mailing address:** 325 AVENUE B NW, WINTER HAVEN, FL 33881-4651
- **Mailing address phone:** (863) 291-4000
- **Mailing address fax:** (863) 299-9179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1063 | FL | Yes |

## Other

- **Enumeration date:** 04/26/2006
- **Last updated:** 10/24/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 079234900 | — | FL |