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Organization

TRAILS EDGE SURGERY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACKY LUCIA (CHIEF ADMINISTRATIVE OFFICER)
(239) 963-7365
Entity
Organization

Contact information

Practice address
28930 TRAILS EDGE BLVD, BONITA SPRINGS, FL 34134-7582
(239) 333-3200
Mailing address
28930 TRAILS EDGE BLVD, BONITA SPRINGS, FL 34134-7582
(239) 333-3200

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
08/23/2018
Last updated
08/23/2018
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