Provider Demographics
NPI:1518621622
Name:VOLUSIA ASC BZ, LLC
Entity type:Organization
Organization Name:VOLUSIA ASC BZ, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPPINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-692-8882
Mailing Address - Street 1:231 S BEMISTON AVE.
Mailing Address - Street 2:SUITE 850, PMB 82567
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1920
Mailing Address - Country:US
Mailing Address - Phone:314-254-0075
Mailing Address - Fax:314-561-7210
Practice Address - Street 1:1601 LPGA BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117
Practice Address - Country:US
Practice Address - Phone:618-973-8740
Practice Address - Fax:618-235-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical