Northwest Florida Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000745 Issued in FL

Legal business name

NORTHWEST FLORIDA SURGERY CENTER, LLC

Practice address

767 Airport Rd
Panama City, FL 32405-4000

Phone

(850) 747-0400

Fax

(850) 913-9744

NPI assigned

Jun 23, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Ron Nmi Samuelian

Title

Ceo

Phone

(850) 747-0400

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Northwest Florida Surgery CenterCCN 10C0001223

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

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1992701049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 AIRPORT RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054000",
            "telephone_number": "850-747-0400",
            "fax_number": "850-913-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 AIRPORT RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054000",
            "telephone_number": "850-747-0400",
            "fax_number": "850-913-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FLORIDA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "SAMUELIAN",
        "authorized_official_first_name": "RON",
        "authorized_official_middle_name": "NMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-747-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "0000745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079169500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "62N",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Florida Surgeons, PA
• North Florida Surgeons, PA
• Vickie North, M.ED.
• Northland Hearing Centers Inc
• Northwest Florida a S C LP
• Andrew W Norton, DMD
• Sarah Novak
• Bethany Parker Nowak, CRNA
• Nathan A Nowak, M.D.
• Vicki G Nowak, M.D.

• Ambulatory Surgical Clinic/Center in Panama City, FL
• Providers in Panama City, 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 Aug 5, 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.