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66101 SUNSET STRIP,LLC

Ambulatory Surgical

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Contact Information

66101 SUNSET STRIP,LLC
40 SOUTH EAST 5TH STREET, SUITE 406
BOCA RATON, FL  33432
 Phone: 561-368-7118
 Fax: 561-368-7116
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Ambulatory Surgical

 261QA1903X 49 Ambulatory Surgical Center
Indicates primary specialty

NPI Profile & details for 66101 SUNSET STRIP,LLC

NPI Number 1235433749
LBN Legal business name 66101 SUNSET STRIP,LLC
Authorized official THOMAS MEDNOLIA - (VP)
Entity Organization
Organization subpart 1 No
Enumeration date 12/28/2010
Last updated 12/28/2010 - About 15 years ago
Identifiers
NJ License # 22512
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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