Ponte Vedra BCH Surgery Clinic

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1215 Issued in FL

Legal business name

PONTE VEDRA BCH SURGERY CLINIC

Practice address

1030 A1A N
Ponte Vedra Beach, FL 32082-4019

Phone

(904) 285-7202

Fax

(904) 285-3931

NPI assigned

Jul 24, 2006

Last updated

Oct 20, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John B Harris, MD

Title

Owner Medical Director

Phone

(904) 285-3931

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1225050974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 A1A N",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824019",
            "telephone_number": "904-285-7202",
            "fax_number": "904-285-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 A1A N",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824019",
            "telephone_number": "904-285-7202",
            "fax_number": "904-285-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTE VEDRA BCH SURGERY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "904-285-3931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lynn Pizzuto, SLP
• Laura Duffy Player, LMHC
• Emily Ann Polatas, LMT
• Tracye Ann Polson, L.C.S.W.
• Ponte Vedra Ambulatory Surgery Center, LLC
• Ponte Vedra Beach Chiropractic Inc
• Ponte Vedra Beach Surgery Center LLC
• Ponte Vedra Chiropractic Medicine & Physical Therapy, Inc.
• Ponte Vedra Cosmetic Dentistry, PA
• Ponte Vedra Counseling LLC (Ponte Vedra Beach Counseling)

• Ambulatory Surgical Clinic/Center in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.