Organization
HEALTHPARK SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERMIT KNIGHT (ADMINISTRATOR)
(941) 492-3958
Entity
Organization
Contact information
Practice address
1283 JACARANDA BLVD, VENICE, FL 34292-4522
(941) 497-5660
Mailing address
1283 JACARANDA BLVD, VENICE, FL 34292-4522
(941) 497-5660
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
951
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64B
BLUE CROSS
FL
Enumeration date
09/22/2006
Last updated
08/22/2020
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