Organization
WEST VOLUSIA SURGICAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL R OGLE M.D. (PRESIDENT)
(407) 443-1865
Entity
Organization
Contact information
Practice address
321 MONTGOMERY RD #160965, ALTAMONTE SPRINGS, FL 32716-0965
(407) 409-8111
(407) 409-8115
Mailing address
321 MONTGOMERY RD #160965, ALTAMONTE SPRINGS, FL 32716-0965
(407) 409-8111
(407) 409-8115
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME98314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278168900
—
FL
Enumeration date
04/23/2010
Last updated
11/24/2014
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