St Marks Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1279 Issued in FL

Legal business name

ST MARKS SURGICAL CENTER LLC

Practice address

6820 International Center Blvd
Fort Myers, FL 33912

Phone

(239) 210-0301

NPI assigned

Dec 12, 2006

Last updated

Mar 3, 2008By 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. Rick Palmon, M.D.

Title

Medical Director

Phone

(239) 768-0006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

St Marks Surgical CenterCCN 10C0001498

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen J. Laquis, M.D.

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1588608624
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1225199482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 INTERNATIONAL CENTER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-210-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 INTERNATIONAL CENTER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-210-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARKS SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "PALMON",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "239-768-0006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jo Squire, OTR/L
• Brittane Squires
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• Annette M St Pierre-Mackoul, MD
• Diane St Pierre, ARNP
• Homecia Carmen St. Clair, CNM
• Jeffrey St. Firmin, PA-C
• St. Johns Surgery Center, LLC

• Ambulatory Surgical Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, 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 Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.