Provider Demographics
NPI:1235896713
Name:VOLUSIA ASC BZ, LLC
Entity Type:Organization
Organization Name:VOLUSIA ASC BZ, LLC
Other - Org Name:ADVANCED HEART AND VASCULAR SURGERY CENTER AT DAYTONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPPINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-692-8882
Mailing Address - Street 1:231 S BEMISTON AVE STE 850
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1920
Mailing Address - Country:US
Mailing Address - Phone:678-642-5118
Mailing Address - Fax:314-561-7210
Practice Address - Street 1:1601 LPGA BLVD.
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117
Practice Address - Country:US
Practice Address - Phone:678-642-5118
Practice Address - Fax:314-561-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical