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Organization
PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC
Active
Organization
PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC
Active
Other names
AdventHealth Surgery Center Port Orange
Organization subpart
No
Provider details
NPI number
Authorized official
MAIRILISE POTHIN OWEN (CFO)
(407) 357-2427
Entity
Organization
Contact information
Practice address
1185 DUNLAWTON AVE STE 100, PORT ORANGE, FL 32127-2906
(386) 777-7151
(386) 231-6545
Mailing address
1185 DUNLAWTON AVE STE 100, PORT ORANGE, FL 32127-2906
(386) 777-7151
(386) 231-6545
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1227
FL
Other
Enumeration date
08/11/2005
Last updated
07/17/2026
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