SAMUEL WELLS SURGICENTER INC (NPI# 1770620742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770620742 |
| Entity Type | Organization |
| Organization Name | SAMUEL WELLS SURGICENTER INC |
| Practice Address |
3599 University Blvd S Ste 604 Jacksonville FL 32216-4234 |
| Practice Telephone | 9043990905 |
| Mailing Telephone | 9043990905 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2012-04-12 |
| Authorized Official Name | DR. LEWIS J OBI (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9043990905 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
390 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 683 | 01 |
| Street Address |
3599 UNIVERSITY BLVD S STE 604 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-4234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932624913 | Eastwood Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 3599 University Blvd S Ste 604, Jacksonville, FL 32216-4234 | 2017-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1104485440 | Surgcenter of Greater Jacksonville, LLC | Clinic/Center | 9143 Philips Hwy Ste 500, Jacksonville, FL 32256-1335 | 2019-06-11 |
| 1366982845 | Jacksonville Endoscopy Centers LLC | Clinic/Center | 1610 Barrs St Ste B, Jacksonville, FL 32204-4569 | 2017-03-02 |
| 1952771602 | Andrews Surgery Center At Jacksonville Medplex LLC | Clinic/Center | 9726 Touchton Road, Jacksonville, FL 32246-8227 | 2015-10-06 |
| 1093772667 | Medical Partners Surgery Center LLC | Clinic/Center | 4545 Emerson Expressway, Jacksonville, FL 32207-4918 | 2006-04-27 |
| 1215990627 | Westside Surgery Center Ltd | Clinic/Center | 2731 Park St, Jacksonville, FL 32205-7607 | 2006-04-07 |
| 1134182546 | Jacksonville Surgery Center, Ltd | Clinic/Center | 7021 A C Skinner Pkwy, Jacksonville, FL 32256-6932 | 2006-04-07 |
| 1588633481 | Bgc Holdings Inc | Clinic/Center | 1610 Barrs St, Jacksonville, FL 32204-4569 | 2006-03-15 |
| 1922085059 | Asc North LLP | Clinic/Center | 590 Dundas Dr, Jacksonville, FL 32218-5579 | 2005-12-29 |
| 1528579034 | Ambulatory Care Specialists of Jacksonville LLC | Clinic/Center | 6820 Southpoint Pkwy, Jacksonville, FL 32216 | 2017-10-24 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
Please comment or provide details below to improve the information on SAMUEL WELLS SURGICENTER INC.
| 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.