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Organization

SURGCENTER OF PINE RIDGE LLC

Active
Other names
BONITA SPRINGS SURGERY CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
COLLIN LEMAISTRE (OFFICER/AUTHORIZED OFFICIAL)
(214) 213-0732
Entity
Organization

Contact information

Practice address
12871 TRADE WAY DR, STE 12, BONITA SPRINGS, FL 34135-7334
(239) 478-0051
Mailing address
12871 TRADE WAY DR, STE 12, BONITA SPRINGS, FL 34135-7334
(239) 478-0051

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
06/16/2021
Last updated
09/10/2024
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