Provider Demographics
NPI:1700887643
Name:MNH SURGICAL CENTER INC
Entity type:Organization
Organization Name:MNH SURGICAL CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILAL
Authorized Official - Suffix:
Authorized Official - Credentials:RPN
Authorized Official - Phone:407-644-4222
Mailing Address - Street 1:1101 N MAITLAND AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4346
Mailing Address - Country:US
Mailing Address - Phone:407-644-4222
Mailing Address - Fax:407-644-5073
Practice Address - Street 1:1101 N MAITLAND AVE
Practice Address - Street 2:STE 2
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4346
Practice Address - Country:US
Practice Address - Phone:407-644-4222
Practice Address - Fax:407-644-5073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1072261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
67TOtherBCBS
5523701OtherAETNA
25825OtherWELLCARE HEALTH PLAN
117543OtherFIRST HEALTH
25825OtherHEALTHEASE
6800745OtherUNITED HEALTH CARE
1027426OtherPHP
FL49504OtherFOUNDATION HEALTH
49004489OtherRAILROAD MEDICARE
25825OtherHEALTHEASE
25825OtherWELLCARE HEALTH PLAN