Provider Demographics
NPI:1326003187
Name:SURGICAL CENTER ASSOCIATES LTD
Entity Type:Organization
Organization Name:SURGICAL CENTER ASSOCIATES LTD
Other - Org Name:WINTER PARK AMBULATORY SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-629-1500
Mailing Address - Street 1:1000 S ORLANDO AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4851
Mailing Address - Country:US
Mailing Address - Phone:407-629-1500
Mailing Address - Fax:407-629-1741
Practice Address - Street 1:1000 S ORLANDO AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4851
Practice Address - Country:US
Practice Address - Phone:407-629-1500
Practice Address - Fax:407-629-1741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1018261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0665033OtherAETNA
FL062932400Medicaid
FL672OtherBCBS PROVIDER NUMBER
FL665033OtherAETNA HMO
FL104324OtherAVMED
FL8204795OtherAETNA PPO
FL0665033OtherAETNA