Organization
PEACE RIVER SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLAI MEJEVOI MD (MEDICAL DIRECTOR)
(941) 629-5356
Entity
Organization
Contact information
Practice address
4130 TAMIAMI TRL UNIT 301, PORT CHARLOTTE, FL 33952-9207
(941) 629-5356
(941) 629-4987
Mailing address
4130 TAMIAMI TRL UNIT 301, PORT CHARLOTTE, FL 33952-9207
(941) 629-5356
(941) 629-4987
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
04/26/2023
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