Provider Demographics
NPI:1356654610
Name:ENDO-SURGICAL CENTER OF FLORIDA
Entity Type:Organization
Organization Name:ENDO-SURGICAL CENTER OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SEELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-506-0006
Mailing Address - Street 1:100 NORTH DEAN ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:407-506-0006
Mailing Address - Fax:407-506-0005
Practice Address - Street 1:100 NORTH DEAN ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825
Practice Address - Country:US
Practice Address - Phone:407-506-0006
Practice Address - Fax:407-506-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
FL261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical