Waters Edge Surgery Center Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

PH20803 Issued in FL

Legal business name

WATERS EDGE SURGERY CENTER INC

Practice address

201 SE Osceola St
Stuart, FL 34994-2210

Phone

(772) 286-9000

Fax

(772) 220-4077

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

Robert Nathan Cooper, M.D.NPI 1841240173

Title

President/Medical Director

Phone

(772) 286-9000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Robert Nathan Cooper, M.D.

  • Plastic Surgery Physician
  • Jupiter, FL
  • NPI 1841240173
  NPD (past) Authorized official

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1447209358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942210",
            "telephone_number": "772-286-9000",
            "fax_number": "772-220-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942210",
            "telephone_number": "772-286-9000",
            "fax_number": "772-220-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERS EDGE SURGERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "772-286-9000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "PH20803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "PH20803",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Matthew Wasylik Jr.
• Agnieszka Waszczuk Marshall, PSY D
• Stephanie Maelynn Waterman
• Waters Edge Dermatology Global LLC
• Waters Edge Recovery, LLC
• Emily Elizabeth Watson
• Holly Watson
• Lindsay A. Watson
• Michele Watson
• Sandra Steiner Watson, PH.D.

• Ambulatory Surgical Clinic/Center in Stuart, FL
• Providers in Stuart, 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 7, 2023; 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.