Provider Demographics
NPI:1801458989
Name:MILLENNIUM SURGERY CENTERS OF FLORIDA, LLC
Entity type:Organization
Organization Name:MILLENNIUM SURGERY CENTERS OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEARNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-674-7400
Mailing Address - Street 1:6321 DANIELS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4773
Mailing Address - Country:US
Mailing Address - Phone:855-674-7400
Mailing Address - Fax:855-674-7400
Practice Address - Street 1:8380 RIVERWALK PARK BLVD STE 220
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-8758
Practice Address - Country:US
Practice Address - Phone:855-674-7400
Practice Address - Fax:855-674-7401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLENNIUM HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-28
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical