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Organization
DESTIN SURGERY CENTER LLC
Active
Organization
DESTIN SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLIN LEMAISTRE (OFFICER/AUTHORIZE OFFICAL)
(214) 213-0732
Entity
Organization
Contact information
Practice address
1225 AIRPORT RD, DESTIN, FL 32541-2909
(850) 650-7606
(850) 337-1698
Mailing address
1225 AIRPORT RD, DESTIN, FL 32541-2909
(850) 650-7606
(850) 337-1698
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1136
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075230400
—
FL
01
—
490005522
RAILROAD MEDICARE
FL
Enumeration date
08/09/2005
Last updated
09/19/2024
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