Organization
ADVANCED SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK P KOTLARZ MD (AUTHORIZED OFFICIAL/OWNER)
(850) 471-2377
Entity
Organization
Contact information
Practice address
6100 N DAVIS HWY, PENSACOLA, FL 32504-6950
(850) 471-2377
(850) 471-9975
Mailing address
6100 N DAVIS HWY, PENSACOLA, FL 32504-6950
(850) 471-2377
(850) 471-9975
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
FL
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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