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Organization
TALLAHASSEE ENDOSCOPY CENTER INC
Active
Organization
TALLAHASSEE ENDOSCOPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE L MADANI (BUSINESS OFFICE MANAGER)
(850) 205-8404
Entity
Organization
Contact information
Practice address
2400 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5314
(850) 205-8404
(850) 216-1321
Mailing address
2400 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5314
(850) 205-8404
(850) 216-1321
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
749
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07069900
FLORIDA MEDICAID NUMBER
FL
01
—
490001580
RRMCR PROVIDER NUMBER
FL
01
—
61E
BCBS PROVIDER NUMBER
FL
Enumeration date
07/23/2006
Last updated
06/05/2008
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