Organization
SURGICAL CENTER OF PONTE VEDRA BEACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY K KASTNER (ADMINISTRATOR)
(407) 256-0933
Entity
Organization
Contact information
Practice address
1030 A1A N, PONTE VEDRA BEACH, FL 32082-4019
(904) 285-1199
Mailing address
1030 A1A N, PONTE VEDRA BEACH, FL 32082-4019
(904) 285-1199
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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