| Organization Name: | SURGICAL CENTER AT SUN N LAKE L L C |
| NPI Number: | 1063675734 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BAHRAM AHMADI (BOARD OF MANAGERS PRESIDENT) |
| Mailing Address: | 4240 Sun N Lake Blvd Suite 100 Sebring |
| State: | FL US |
| Postal Code: | 338721986 |
| Phone Number: | 8633822622 |
| Fax Number: | 8633852266 |
| NPI Enumeration Date: | 07/03/2008 |
| NPI Last Update Date: | 04/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |