Provider Demographics
NPI:1275822496
Name:ISLAND SURGICAL CARE, INC.
Entity Type:Organization
Organization Name:ISLAND SURGICAL CARE, INC.
Other - Org Name:ROSE S.M. CHAN, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIU-MEI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-292-5812
Mailing Address - Street 1:3845 SEASIDE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-5296
Mailing Address - Country:US
Mailing Address - Phone:305-292-5812
Mailing Address - Fax:305-292-5815
Practice Address - Street 1:3845 SEASIDE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-5296
Practice Address - Country:US
Practice Address - Phone:305-292-5812
Practice Address - Fax:305-292-5815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty