Organization
PREMIER ADULT AND CHILDRENS SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (OFFICER/AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
5238 MASON CORBIN CT STE 101, FORT MYERS, FL 33907-7738
(239) 936-9700
(239) 936-9707
Mailing address
5238 MASON CORBIN CT STE 101, FORT MYERS, FL 33907-7738
(239) 936-9700
(239) 936-9707
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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