Organization
WINTER HAVEN AMBULATORY SURGICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLIN LEMAISTRE (OFFICER/AUTHORIZED OFFICIAL)
(469) 250-3640
Entity
Organization
Contact information
Practice address
325 AVE B NW, WINTER HAVEN, FL 33881
(863) 291-4000
(863) 299-9179
Mailing address
325 AVENUE B NW, WINTER HAVEN, FL 33881-4651
(863) 291-4000
(863) 299-9179
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079234900
—
FL
Enumeration date
04/26/2006
Last updated
10/24/2024
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