Provider Demographics
NPI:1831140151
Name:ASC GAMMA PARTNERS LTD
Entity Type:Organization
Organization Name:ASC GAMMA PARTNERS LTD
Other - Org Name:MIAMI SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER AND AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:B
Authorized Official - Last Name:BALDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-234-5924
Mailing Address - Street 1:7600 SW 87TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3635
Mailing Address - Country:US
Mailing Address - Phone:305-595-2414
Mailing Address - Fax:305-595-5140
Practice Address - Street 1:7600 SW 87TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3635
Practice Address - Country:US
Practice Address - Phone:305-595-2414
Practice Address - Fax:305-595-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1173261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF1400Medicare ID - Type Unspecified