Organization
AESCULAPIAN SURGERY CENTER, LLC
Active
Other names
Intercoastal Medical Group Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY G SIMON FACMPE (CEO/ADMINISTRATOR)
(941) 955-1108
Entity
Organization
Contact information
Practice address
3333 CATTLEMEN RD, SUITE 100, SARASOTA, FL 34232-6056
(941) 379-5884
(941) 379-1760
Mailing address
3333 CATTLEMEN RD, SUITE 100, SARASOTA, FL 34232-6056
(941) 379-5884
(941) 379-1760
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1181
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075718700
—
FL
Enumeration date
02/09/2006
Last updated
08/17/2016
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