Provider Demographics
NPI:1366898819
Name:MILLENIA SURGERY CENTER LLC
Entity type:Organization
Organization Name:MILLENIA SURGERY CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-569-6500
Mailing Address - Street 1:4901 VINELAND RD
Mailing Address - Street 2:STE 150
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-7300
Mailing Address - Country:US
Mailing Address - Phone:407-370-3272
Mailing Address - Fax:407-370-3028
Practice Address - Street 1:4901 VINELAND RD
Practice Address - Street 2:STE 150
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-7300
Practice Address - Country:US
Practice Address - Phone:407-370-3272
Practice Address - Fax:407-370-3028
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SURGERY CENTER HOLDINGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty