Provider Demographics
NPI:1902191448
Name:KVH SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:KVH SURGERY CENTER, LLC
Other - Org Name:AESTHETIC PLASTIC SURGERY &MED SPA OF NAPLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:HASEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-262-5662
Mailing Address - Street 1:3699 AIRPORT PULLING RD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-8516
Mailing Address - Country:US
Mailing Address - Phone:239-262-5662
Mailing Address - Fax:239-244-8278
Practice Address - Street 1:3699 AIRPORT PULLING RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8516
Practice Address - Country:US
Practice Address - Phone:239-262-5662
Practice Address - Fax:239-244-8278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 84935261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical