SURGERY CENTER OF VOLUSIA, LLC (NPI# 1407873292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407873292 |
| Entity Type | Organization |
| Organization Name | SURGERY CENTER OF VOLUSIA, LLC |
| Other Organization Name | SURGERY CENTER OF VOLUSIA |
| Practice Address |
3635 S Clyde Morris Blvd Suite 500 Port Orange FL 32129-2300 |
| Practice Telephone | 3867608151 |
| Practice Fax Number | 3867608185 |
| Mailing Telephone | 3867608151 |
| Mailing Fax Number | 3867608185 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2014-04-03 |
| Authorized Official Name | MR. PHILLIP A. CLENDENIN (PRESIDENT) |
| Authorized Official Telephone | 6156651283 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
1175 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | P00073662 | 01 |
| FL | 075540100 | 05 |
| Other Name | Type Code |
|---|---|
| Surgery Center of Volusia | Doing Business As Name - Organization |
| Street Address |
3635 S CLYDE MORRIS BLVD SUITE 500 |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033116975 | Gregory J. Stella | Internal Medicine | 3635 S Clyde Morris Blvd, Ste 100, Port Orange, FL 32129-2300 | 2005-07-07 |
| 1043690902 | C B Williamson | Orthopaedic Surgery | 3635 S Clyde Morris Blvd, Ste 600, Port Orange, FL 32129-2300 | 2015-06-05 |
| 1487050365 | Michel C. Samson, M.d., F.a.c.s., Pllc | Plastic Surgery | 3635 S Clyde Morris Blvd, Suite 400, Port Orange, FL 32129-2300 | 2014-11-05 |
| 1043654270 | Amsurg Port Orange Anesthesia, LLC | Anesthesiology | 3635 S Clyde Morris Blvd, Suite 500, Port Orange, FL 32129-2300 | 2013-04-18 |
| 1871849133 | Dorothy Whatley Porter | Physician Assistant | 3635 S Clyde Morris Blvd, Suite 100, Port Orange, FL 32129-2300 | 2012-07-24 |
| 1578836003 | C. Lawrence Slade, M.d., F.a.c.s., LLC | Specialist | 3635 S Clyde Morris Blvd, Suite 400, Port Orange, FL 32129-2300 | 2012-02-14 |
| 1841596327 | Srikanth Eathiraju | Orthopaedic Surgery | 3635 S Clyde Morris Blvd, Suite 900, Port Orange, FL 32129-2300 | 2011-02-01 |
| 1043520554 | C Lawrence Slade Md Facs LLC | Plastic Surgery | 3635 S Clyde Morris Blvd, Suite 400, Port Orange, FL 32129-2300 | 2010-10-18 |
| 1265693568 | Sarah E Henry | Orthopaedic Surgery | 3635 S Clyde Morris Blvd, Suite 900, Port Orange, FL 32129-2300 | 2008-06-19 |
| 1356519417 | Joanna Elizabeth Stoverink | Physician Assistant | 3635 S Clyde Morris Blvd, Ste 100, Port Orange, FL 32129-2300 | 2008-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
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| 1437764321 | Baptist Health Surgery Center, LLC | Clinic/Center | 1228 S Pine Island Rd Ste 220, Plantation, FL 33324-4402 | 2020-09-09 |
| 1538773890 | Asc of Trinity | Clinic/Center | 15238 Virginia Station, Odessa, FL 33556 | 2020-09-03 |
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1780292359 | Gemini Ambulatory Surgical Center Incorporated | Clinic/Center | 7661 Lake Worth Rd, Lake Worth, FL 33467-2534 | 2020-07-20 |
| 1891312815 | Sacred Heart Asc, LLC | Clinic/Center | 1890 Summit Boulevard, Suite 210, Pensacola, FL 32503 | 2020-06-26 |
| 1578188983 | Miami Beach Surgery Center, LLC | Clinic/Center | 400 W 41st St Ste 512, Miami Beach, FL 33140-3517 | 2020-06-11 |
| 1346865078 | Panhandle Outpatient Surgery Center | Clinic/Center | 1502 Creighton Rd Ste C, Pensacola, FL 32504-7143 | 2020-06-09 |
| 1033734793 | Naples Suncoast Surgery Center LLC | Clinic/Center | 2500 Goodlette Frank Rd Ste 200, Naples, FL 34103-4608 | 2020-06-09 |
| 1710501879 | Hz Surgery Center LLC | Clinic/Center | 17085 Porter Road, Suite 110, Winter Garden, FL 34787 | 2020-06-04 |
| Find all providers with the same taxonomy | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
Please comment or provide details below to improve the information on SURGERY CENTER OF VOLUSIA, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.