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Organization
THE KISSIMMEE FL ENDOSCOPY ASC LLC
Active
Organization
THE KISSIMMEE FL ENDOSCOPY ASC LLC
Active
Other names
Kissimmee Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
715 OAK COMMONS BLVD, KISSIMMEE, FL 34741-4213
(407) 931-2816
(407) 931-3485
Mailing address
1A BURTON HILLS BLVD # L&C, NASHVILLE, TN 37215-6187
(615) 240-3820
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076847200
MEDICAID
FL
01
—
P00665695
RAILROAD MEDICARE
FL
Enumeration date
12/17/2007
Last updated
11/01/2022
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