Provider Demographics
NPI:1710057534
Name:NOVAMED SURGERY CENTER OF SEBRING LLC
Entity Type:Organization
Organization Name:NOVAMED SURGERY CENTER OF SEBRING LLC
Other - Org Name:SURGICAL CENTER OF CENTRAL FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:MACOMBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-780-3234
Mailing Address - Street 1:3601 S HIGHLANDS AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5418
Mailing Address - Country:US
Mailing Address - Phone:863-382-7500
Mailing Address - Fax:863-385-7332
Practice Address - Street 1:3601 S HIGHLANDS AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5418
Practice Address - Country:US
Practice Address - Phone:863-382-7500
Practice Address - Fax:863-385-7332
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVAMED, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-09
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL805261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical