Organization
CORDOVA AMBULATORY SURGICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE FERNANDEZ (ADMINISTRATION)
(850) 477-5110
Entity
Organization
Contact information
Practice address
545 BRENT LN, PENSACOLA, FL 32503-2003
(850) 477-5110
(850) 477-7548
Mailing address
545 BRENT LN, PENSACOLA, FL 32503-2003
(850) 477-5110
(850) 477-7548
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
768
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079046000
—
FL
Enumeration date
07/08/2006
Last updated
02/27/2012
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