Provider Demographics
NPI:1174526271
Name:ORLANDO SURGERY CENTER II LTD
Entity type:Organization
Organization Name:ORLANDO SURGERY CENTER II LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUENER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-897-2000
Mailing Address - Street 1:2000 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5533
Mailing Address - Country:US
Mailing Address - Phone:407-897-2000
Mailing Address - Fax:407-897-5192
Practice Address - Street 1:2000 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5533
Practice Address - Country:US
Practice Address - Phone:407-897-2000
Practice Address - Fax:407-897-5192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QA1903X261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF1266Medicare ID - Type Unspecified