Organization
SPACE COAST SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER B BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
595 N COURTENAY PKWY, 103, MERRITT ISLAND, FL 32953-4851
(813) 569-6500
Mailing address
595 N COURTENAY PKWY STE 103, MERRITT ISLAND, FL 32953-4852
(813) 890-1800
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/05/2009
Last updated
11/01/2022
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