Organization
CORAL SPRINGS AMBULATORY SURGERY CENTER LLC
Active
Other names
Coral Springs Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP A. CLENDENIN (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
1725 UNIVERSITY DRIVE, 2ND FLOOR, CORAL SPRINGS, FL 33071
(954) 227-7760
(954) 227-9975
Mailing address
1725 UNIVERSITY DRIVE, 2ND FLOOR, CORAL SPRINGS, FL 33071
(954) 227-7760
(954) 227-9975
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070313300
—
FL
01
—
215430
AMERIGROUP
—
01
—
2167675
AETNA
FL
01
—
261016
AVMED
—
01
—
30734
NEIGHBORHOOD
—
01
—
63K
BC
FL
01
—
SG013546
VISTA
—
Enumeration date
05/10/2006
Last updated
09/07/2023
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