Organization
MELBOURNE SURGERY CENTER, LLC
Active
Other names
Melbourne Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
PETER J CLEMENS IV (VP)
(205) 545-2572
Entity
Organization
Contact information
Practice address
95 BULLDOG BLVD, SUITE 104, MELBOURNE, FL 32901-3332
(321) 952-9800
Mailing address
95 BULLDOG BLVD, SUITE 104, MELBOURNE, FL 32901-3332
(321) 952-9800
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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