Organization
ELITE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA L LACERNA KIMBRELL M.D. (MANAGER/MEMBER)
(941) 954-4500
Entity
Organization
Contact information
Practice address
5301 4TH AVE CIRCLE E, BRADENTON, FL 34208
(941) 954-4500
Mailing address
5301 4TH AVE CIRCLE E, BRADENTON, FL 34208
(941) 954-4500
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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