Provider Demographics
NPI:1891457099
Name:WINTER GARDEN SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:WINTER GARDEN SURGERY CENTER, LLC
Other - Org Name:WINTER GARDEN SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:OHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-843-2355
Mailing Address - Street 1:15520 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-9556
Mailing Address - Country:US
Mailing Address - Phone:321-277-2376
Mailing Address - Fax:
Practice Address - Street 1:15520 W COLONIAL DR UNIT H
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-9556
Practice Address - Country:US
Practice Address - Phone:321-277-2376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical