Organization
ORANGE PARK ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLIN LEMAISTRE (OFFICER/AUTHORIZED OFFICIAL)
(469) 250-3640
Entity
Organization
Contact information
Practice address
805 WELLS RD, ORANGE PARK, FL 32073-2301
(469) 872-4706
Mailing address
14201 DALLAS PKWY, DALLAS, TX 75254-2916
(469) 872-4706
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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