Organization
CAPE CORAL AMBULATORY SURGERY CENTER, LLC
Active
Other names
Cape Coral Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
2721 DEL PRADO BLVD S, SUITE 100, CAPE CORAL, FL 33904-5781
(239) 242-8010
(239) 242-8020
Mailing address
2721 DEL PRADO BLVD S, SUITE 100, CAPE CORAL, FL 33904-5781
(239) 242-8010
(239) 242-8020
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1245
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6N1
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
05/31/2006
Last updated
03/01/2023
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