Organization
PROMENADES SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISSA F BAROUDI M.D. (MEDICAL DIRECTOR)
(941) 627-5155
Entity
Organization
Contact information
Practice address
3222 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8048
(941) 627-5155
Mailing address
3222 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8048
(941) 627-5155
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1149
FL
Other
Enumeration date
06/11/2006
Last updated
01/14/2013
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