Provider Demographics
NPI:1073758298
Name:BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC
Entity Type:Organization
Organization Name:BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC
Other - Org Name:BAPTIST HEALTH ENDOSCOPY CENTER AT GALLOWAY NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BATISTA-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-662-7111
Mailing Address - Street 1:6855 RED ROAD
Mailing Address - Street 2:STE 500
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3623
Mailing Address - Country:US
Mailing Address - Phone:786-662-7980
Mailing Address - Fax:786-533-9403
Practice Address - Street 1:7500 SW 87TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5426
Practice Address - Country:US
Practice Address - Phone:305-595-9511
Practice Address - Fax:305-271-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QA1903X, 261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000788200Medicaid
68-00264OtherUNITED MEDICARE
16092OtherMEDICA
2558072OtherUNITED
1211778OtherAETNA HMO
F00255807203OtherNEIGHBORHOOD
602OtherBLUE CROSS BLUE SHIELD
7325793OtherAETNA NON-HMO
298398OtherAVMED
602OtherBLUE CROSS BLUE SHIELD
7325793OtherAETNA NON-HMO
=========OtherCIGNA
=========OtherHUMANA CLASSIC
=========OtherJMH HEALTH PLAN
F00255807203OtherNEIGHBORHOOD
=========OtherFIRST HEALTH
16092OtherMEDICA
68-00264OtherUNITED MEDICARE
=========OtherHUMANA CHOICE
=========OtherCORVEL
=========OtherPRIVATE HEALTHCARE SYSTEMS
FL000788200Medicaid
FL000788200Medicaid