Organization
ADVANCED SURGERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD M. COWIN D.P.M. (OWNER/PRESIDENT)
(352) 245-9562
Entity
Organization
Contact information
Practice address
10900 SE 174TH PLACE RD, SUMMERFIELD, FL 34491-8984
(352) 245-9562
(352) 245-9563
Mailing address
10900 SE 174TH PLACE RD, SUMMERFIELD, FL 34491-8984
(352) 245-9562
(352) 245-9563
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6H6
BLUE CROSS & BLUE SHIELD
FL
Enumeration date
10/13/2005
Last updated
08/22/2020
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