Surgical Center of Ponte Vedra Beach LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1215 Issued in FL

Legal business name

SURGICAL CENTER OF PONTE VEDRA BEACH LLC

Practice address

1030 A1A N
Ponte Vedra Beach, FL 32082-4019

Phone

(907) 285-1199

Fax

(907) 285-1197

NPI assigned

Mar 6, 2015

Organization subpart

No

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

Authorized official

Name

Krystyn Collier

Title

Manager

Phone

(904) 285-1199

Specialties & licenses 1

Addresses

Other names 1

• Ponte Vedra Beach Surgery Center Doing business as

Practitioners 1

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

• Timothy Luke Schneider, M.D.

  • Ophthalmology Physician
  • Jacksonville Beach, FL
  • NPI 1730181983
  NPD

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1609269232",
    "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": "907-285-1199",
            "fax_number": "907-285-1197"
        },
        {
            "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": "907-285-1199",
            "fax_number": "907-285-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL CENTER OF PONTE VEDRA BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-06",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "KRYSTYN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-285-1199"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ponte Vedra Beach Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ponte Vedra Beach Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexa Elyse Stubenrauch, M.S. CCC-SLP
• Successful Pathways to Wellness
• Sunny Dentistry PLLC
• Sunrise Orthodontics PLLC
• Surgery Center of Ponte Vedra Beach LLC
• Surgical Center of Ponte Vedra Beach, LLC
• Anna Swan
• Liudmyla Sysa, MD
• Duane F Szczepanski, M.D.
• Lilia Joy Tabassian, DMD

• 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 Jul 29, 2019; 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.