Memorial Surgicare LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

AHCA989 Issued in FL

Legal business name

MEMORIAL SURGICARE LTD

Doing business as

Plaza Surgery Center

Practice address

3901 University Blvd S
Suite 111
Jacksonville, FL 32216-4377

Phone

(904) 448-1948

Fax

(904) 448-8889

NPI assigned

Apr 7, 2006

Last updated

Jul 8, 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

Don Liedtke

Title

Vice President

Phone

(615) 344-5507

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Plaza Surgery Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Memorial Healthcare Group Inc

  dba HCA Florida Memorial Hospital

  • Psychiatric Hospital Unit
  • Jacksonville, FL
  • NPI 1083997779

  Member Of

  NPD member

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.

• Davood Sooriash, M.D.

  • Surgery Physician
  • Marion, IL
  • NPI 1093828964
  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1942263363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "address_2": "SUITE 111",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164377",
            "telephone_number": "904-448-1948",
            "fax_number": "904-448-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "address_2": "SUITE 111",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164377",
            "telephone_number": "904-448-1948",
            "fax_number": "904-448-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL SURGICARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "LIEDTKE",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-344-5507"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "AHCA989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079198900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plaza Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Memorial Healthcare Group, Inc. (HCA Florida Mandarin Emergency, a department of HCA Florida Memorial Hospital)
• Memorial Hospital
• Memorial Neurosurgery Group LLC (Memorial Neuroscience Center)
• Memorial Neurosurgery Group LLC
• Memorial Southside Cancer Center LLC (Memorial Cancer Center)
• Memorial Urgent Care Mandarin LLC
• Memory Coast Emergency Physicians, LLC
• Memory Coast Emergency Physicians, LLC
• Ashley Men, APRN
• Deanna Menapace, M.D.

• Ambulatory Surgical Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, 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 8, 2008; 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.