Organization
LAKEWOOD ASC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE A RIVERA (ADMINISTRATOR)
(352) 643-9080
Entity
Organization
Contact information
Practice address
5571 E SR 44 STE 501, WILDWOOD, FL 34785-8282
(352) 643-9080
(352) 571-6786
Mailing address
5571 E SR 44 STE 501, WILDWOOD, FL 34785-8282
(352) 643-9080
(352) 571-6786
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
10/21/2020
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