Organization
THE KISSIMMEE FL ENDOSCOPY ASC LLC
Active
Other names
Kissimmee Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
715 OAK COMMONS BLVD, KISSIMMEE, FL 34741-4213
(407) 931-2816
(407) 931-3485
Mailing address
1A BURTON HILLS BLVD # L&C, NASHVILLE, TN 37215-6187
(615) 240-3820
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076847200
MEDICAID
FL
01
—
P00665695
RAILROAD MEDICARE
FL
Enumeration date
12/17/2007
Last updated
11/01/2022
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