Provider Demographics
NPI:1679704456
Name:ORLANDO ORTHOPAEDIC OUTPATIENT SURGERY CENTER LLC
Entity Type:Organization
Organization Name:ORLANDO ORTHOPAEDIC OUTPATIENT SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCROGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-630-6277
Mailing Address - Street 1:45 W CRYSTAL LAKE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4435
Mailing Address - Country:US
Mailing Address - Phone:407-254-2526
Mailing Address - Fax:
Practice Address - Street 1:45 W CRYSTAL LAKE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4435
Practice Address - Country:US
Practice Address - Phone:407-254-2526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical