Organization
BAPTIST MEDICAL PARK SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PORTER VP (CHAIRMAN OF THE BOARD)
(850) 469-2338
Entity
Organization
Contact information
Practice address
9400 UNIVERSITY PKWY, SUITE 102, PENSACOLA, FL 32514-5752
(850) 208-6330
(850) 208-6335
Mailing address
9400 UNIVERSITY PKWY, SUITE 102, PENSACOLA, FL 32514-5752
(850) 208-6330
(850) 208-6335
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
412
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070620500
—
FL
Enumeration date
03/12/2015
Last updated
03/12/2015
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