Provider Demographics
NPI:1134501620
Name:THE DOCTORS SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:THE DOCTORS SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HUSNI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARARA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:239-872-2467
Mailing Address - Street 1:7431 GLADIOLUS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5122
Mailing Address - Country:US
Mailing Address - Phone:239-872-2467
Mailing Address - Fax:
Practice Address - Street 1:7431 GLADIOLUS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5122
Practice Address - Country:US
Practice Address - Phone:239-872-2467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical