Organization
AMBULATORY SURGERY CENTER OF BALA CYNWYD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL THOMAS TRICOLI ESQ. (COUNSEL)
(407) 947-3084
Entity
Organization
Contact information
Practice address
100 PRESIDENTIAL BLVD FL 4, BALA CYNWYD, PA 19004-1108
(407) 960-7990
(321) 972-4252
Mailing address
660 PALM SPRINGS DR STE C, ALTAMONTE SPRINGS, FL 32701-7864
(407) 960-7990
(321) 972-4252
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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