Organization
DELAND SURGERY CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL A CAVANAGH (ADMINISTRATOR)
(386) 738-6811
Entity
Organization
Contact information
Practice address
651 W PLYMOUTH AVE, DELAND, FL 32720-3259
(386) 738-6811
Mailing address
651 W PLYMOUTH AVE, DELAND, FL 32720-3259
(386) 738-6811
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
809
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64T
BCBS
FL
Enumeration date
06/10/2005
Last updated
04/01/2008
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