Provider Demographics
NPI:1598096323
Name:NEXTMED LASER, LLC
Entity Type:Organization
Organization Name:NEXTMED LASER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER OF ABS
Authorized Official - Prefix:
Authorized Official - First Name:LACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-258-0326
Mailing Address - Street 1:6339 E. SPEEDWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1147
Mailing Address - Country:US
Mailing Address - Phone:520-547-4130
Mailing Address - Fax:520-258-0304
Practice Address - Street 1:800 OCALA RD # 300346
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-1669
Practice Address - Country:US
Practice Address - Phone:520-547-4130
Practice Address - Fax:520-258-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-18
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical