Provider Demographics
NPI:1053985721
Name:ENDO SURGICAL CENTER OF KISSIMMEE, PLLC
Entity type:Organization
Organization Name:ENDO SURGICAL CENTER OF KISSIMMEE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SEELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-384-7388
Mailing Address - Street 1:737 W OAK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4936
Mailing Address - Country:US
Mailing Address - Phone:407-384-7388
Mailing Address - Fax:407-384-7391
Practice Address - Street 1:737 W OAK ST STE 201
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4936
Practice Address - Country:US
Practice Address - Phone:407-384-7388
Practice Address - Fax:407-384-7391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical