Provider Demographics
NPI:1639237092
Name:MUSCULOSKELETAL AMBULATORY SURGERY CENTER INC
Entity Type:Organization
Organization Name:MUSCULOSKELETAL AMBULATORY SURGERY CENTER INC
Other - Org Name:THE SURGERY CENTER AT POINTE WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SANTINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-782-0101
Mailing Address - Street 1:8000 SR 64 EAST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212
Mailing Address - Country:US
Mailing Address - Phone:941-782-0101
Mailing Address - Fax:941-794-1863
Practice Address - Street 1:8000 SR 64 EAST
Practice Address - Street 2:SUITE 205
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-3421
Practice Address - Country:US
Practice Address - Phone:941-782-0101
Practice Address - Fax:941-748-8587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1093261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL67VOtherBCBS FL
FLP00149986OtherRAILROAD MEDICARE
FL75448000Medicaid
FLF1321Medicare PIN