Organization
SURGERY ONE IPA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL TIMOTHY MCMANUS (EXECUTIVE DIRECTOR)
(407) 816-5031
Entity
Organization
Contact information
Practice address
1003 E WALLACE ST, ORLANDO, FL 32809-5172
(407) 816-5031
Mailing address
1003 E WALLACE ST, ORLANDO, FL 32809-5172
(407) 816-5031
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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