West Volusia Surgical, PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME98314 Issued in FL

Legal business name

WEST VOLUSIA SURGICAL, PA

Practice address

321 Montgomery Rd #160965
Altamonte Springs, FL 32716-0965

Phone

(407) 409-8111

Fax

(407) 409-8115

NPI assigned

Apr 23, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel R Ogle, M.D.

Title

President

Phone

(407) 443-1865

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1023335437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MONTGOMERY RD #160965",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327160965",
            "telephone_number": "407-409-8111",
            "fax_number": "407-409-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MONTGOMERY RD #160965",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327160965",
            "telephone_number": "407-409-8111",
            "fax_number": "407-409-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VOLUSIA SURGICAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "OGLE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-443-1865",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME98314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278168900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Michelle Wenig, MA, LMHC, NCC
• Mathew Wentworth, M.S., BCBA
• West Altamonte Facility Operations, LLC
• West Altamonte Nursing and Rehabilitation Center by Harborview LLC
• West Altamonte Opco, LLC
• Domonic Lane Westergaard, APRN, MSN, PPCNP-BC
• Jordan Samantha Wetter, COTA/L
• Sydney Wetterstrom
• Ross C. Wheeler, M.D.
• Winifred G Whidden, ARNP

• All providers in Altamonte Springs, FL
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.