Organization
PANAMA CITY SURGERY CENTER,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL MADEWELL (ADMINISTRATOR)
(850) 769-3191
Entity
Organization
Contact information
Practice address
1800 JENKS AVE, PANAMA CITY, FL 32405-4642
(850) 769-3191
(850) 769-3192
Mailing address
1800 JENKS AVE, PANAMA CITY, FL 32405-4642
(850) 769-3191
(850) 769-3192
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1178
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075701200
—
FL
Enumeration date
01/26/2006
Last updated
07/29/2022
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