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Organization

SPACE COAST SURGICAL CENTER LTD

Active
Other names
Merritt Island Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
CYNTHIA A JOHNSON (ADMINISTRATOR)
(321) 459-0015
Entity
Organization

Contact information

Practice address
220 N SYKES CREEK PKWY, SUITE 101, MERRITT ISLAND, FL 32953-3490
(321) 459-0015
(321) 459-2291
Mailing address
220 N SYKES CREEK PKWY, SUITE 101, MERRITT ISLAND, FL 32953-3490
(321) 459-0015
(321) 459-2291

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
984
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
079154700
FL
Enumeration date
04/10/2006
Last updated
03/28/2016
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