Organization
RINEHART LAKE MARY SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL M. MODICA RN,LHRM (ADMINISTRATOR)
(407) 708-5383
Entity
Organization
Contact information
Practice address
917 RINEHART RD, SUITE 1001, LAKE MARY, FL 32746-4802
(407) 708-5383
(407) 708-5396
Mailing address
917 RINEHART RD, SUITE 1001, LAKE MARY, FL 32746-4802
(407) 708-5383
(407) 708-5396
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1225
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225
ASC LICENSE
FL
Enumeration date
07/11/2005
Last updated
08/22/2020
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