Organization
FAIRCLOTH SURGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IEDA FAIRCLOTH (PRESIDENT/CEO)
(954) 270-9673
Entity
Organization
Contact information
Practice address
4811 NW 103RD DR, CORAL SPRINGS, FL 33076-1725
(954) 270-9673
Mailing address
4811 NW 103RD DR, CORAL SPRINGS, FL 33076-1725
(954) 270-9673
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/24/2017
Last updated
07/21/2022
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