| Organization Name: | THE SURGERY CENTER AT JENSEN BEACH, LLC |
| NPI Number: | 1093772840 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL K. BURTNETT (PRES. MANAGING MMBER) |
| Mailing Address: | 3995 Nw Golden Rod Road Jensen Beach |
| State: | FL US |
| Postal Code: | 34957 |
| Phone Number: | 7724970020 |
| Fax Number: | 7724970021 |
| NPI Enumeration Date: | 04/26/2006 |
| NPI Last Update Date: | 04/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 1197 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |