Promenades Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1149 Issued in FL

Legal business name

PROMENADES SURGERY CENTER LLC

Practice address

3222 Tamiami TRL
Port Charlotte, FL 33952-8048

Phone

(941) 627-5155

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Issa F Baroudi, M.D.NPI 1558303966

Title

Medical Director

Phone

(941) 627-5155

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Promenades Surgery Center LLCCCN 10C0001376

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Issa F Baroudi, M.D.

  • Specialist
  • Port Charlotte, FL
  • NPI 1558303966
  NPD Authorized official

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1336181742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528048",
            "telephone_number": "941-627-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3222 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528048",
            "telephone_number": "941-627-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMENADES SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "BAROUDI",
        "authorized_official_first_name": "ISSA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "941-627-5155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Carolina Proano, MD
• Ann Marie Profetto, APRN
• Progressive Optical Designs
• Progressive Physical Therapy Service Inc.
• Promenades Dermatology, LLC
• Joseph D Proscia, DDS
• Karen Przytulski, RD
• Psychotherapy With Allyson Fellows, LLC
• Publix Super Markets Inc (Publix Pharmacy #1438)
• Publix Super Markets Inc (Publix Pharmacy #0778)

• Ambulatory Surgical Clinic/Center in Port Charlotte, FL
• Providers in Port Charlotte, 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 Jan 14, 2013; 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.