Organization
AMBULATORY SURGICAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK HARRIS (ADMINISTRATOR)
(321) 453-3937
Entity
Organization
Contact information
Practice address
1045 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4531
(321) 453-3937
(321) 452-5404
Mailing address
1045 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4531
(321) 453-3937
(321) 452-5404
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
849
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079072900
—
FL
01
—
61L
BC/BS PROVIDER NUMBER
FL
Enumeration date
07/07/2006
Last updated
05/20/2013
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