Organization
AMELIA ISLAND SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON GULLY (GROUP VICE PRESIDENT)
(913) 387-0572
Entity
Organization
Contact information
Practice address
2461 LYNNDALE RD, FERNANDINA BEACH, FL 32034
(913) 226-3401
Mailing address
2461 LYNNDALE RD, FERNANDINA BEACH, FL 32034
(913) 226-3401
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/27/2007
Last updated
05/15/2008
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