Provider Demographics
NPI:1245628767
Name:FLORENCE SURGERY & LASER CENTER ANESTHESIA, LLC
Entity type:Organization
Organization Name:FLORENCE SURGERY & LASER CENTER ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-664-9398
Mailing Address - Street 1:400 N CASHUA DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-2098
Mailing Address - Country:US
Mailing Address - Phone:843-664-9398
Mailing Address - Fax:
Practice Address - Street 1:400 N CASHUA DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-2098
Practice Address - Country:US
Practice Address - Phone:843-664-9398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty