Organization
SURGICAL ASSOCIATES OF VENICE AND ENGLEWOOD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBIE LONG (PRACTICE ADMINISTRATOR)
(941) 484-7506
Entity
Organization
Contact information
Practice address
436 NOKOMIS AVE S, VENICE, FL 34285-2617
(941) 488-7742
(941) 484-7756
Mailing address
436 NOKOMIS AVE S, VENICE, FL 34285-2617
(941) 445-5054
(941) 303-6796
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00778
BLUE CROSS BLUE SHIELD
FL
01
—
CB1948
RAILROAD MEDICARE
FL
Enumeration date
01/29/2007
Last updated
03/14/2022
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