Organization
EAST WEST LASER AND AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL A. PECORARO M.D. (MANAGER)
(904) 272-2020
Entity
Organization
Contact information
Practice address
1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL 32003
(561) 630-6277
(561) 630-6062
Mailing address
1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL 32003
(561) 630-6277
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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