Heathrow Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HEATHROW SURGERY CENTER LLC

Practice address

942 International Pkwy
Lake Mary, FL 32746-5219

Phone

(404) 953-4095

Fax

(404) 410-1211

NPI assigned

Nov 11, 2021

Last updated

Feb 10, 2025By 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

Candice Brown Davis

Title

VP

Phone

(916) 990-7590

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Heathrow Surgery Center LLCCCN 10C0001723

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

Locations

Practitioners 3

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.

• Kevin M Barber, MD

  • Ophthalmology Physician
  • Deland, FL
  • NPI 1184612269
  NPD
• Ryan Scruggs, MD

  • Ophthalmology Physician
  • Deland, FL
  • NPI 1891954608
  NPD
• Bao Truong, MD

  • Ophthalmology Physician
  • Saint Cloud, FL
  • NPI 1518487784
  NPD (past)

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1316603699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 GLENRIDGE DR STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 INTERNATIONAL PKWY",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465219",
            "telephone_number": "404-953-4095",
            "fax_number": "404-410-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHROW SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-11",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "BROWN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "916-990-7590"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heathrow Family Chiropractic
• Heathrow Imaging LLC
• Heathrow Imaging LLC
• Heathrow Internal Medicine LLC
• Heathrow Psychology, LLC
• Heathrow Urgent Care Inc
• Susan Hedberg, OT
• Corey A Heichel, P.A.-C.
• Jacqueline A Heiny
• Scott Robert Heinz, PA-C

• Ambulatory Surgical Clinic/Center in Lake Mary, FL
• Providers in Lake Mary, 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 Feb 10, 2025; 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.