SAMUEL WELLS SURGICENTER INC
Ambulatory Health at University Blvd, Jacksonville, FL

License number
Florida 390
Category
Ambulatory Health
Type
Ambulatory Surgical
Owner
Name: DR. LEWIS J OBI MD
Title: MEDICAL DIRECTOR
Phone: (904) 399-0905
Address
Address
3599 University Blvd S STE 604, Jacksonville, FL 32216
National Provider ID: 1770620742
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SAMUEL WELLS SURGICENTER, INC

3599 University Blvd SUITE 604, Jacksonville, FL 32216

Status:
Inactive
Industry:
General Medical & Surgical Hospitals
Doing business as:
Samuel Wells Surgicenter
Inactive reason:
NAME CHANGE AMENDMENT
Registration:
Jun 25, 1992
Inactive since:
Mar 6, 1995
Site:
obiplasticsurgery.com
Phone:
(904) 399-0905 (Phone), (904) 346-0757 (Fax)
State ID:
V47477
Business type:
Florida Profit Corporation
Managers:
Lewis J Obi (President, Treasurer, Secretary, Director), 3599 University Blvd S #604, Jacksonville, FL (Physical),Bairstow-Obi, Myra, 3599 University Blvd S #604, Jacksonville, FL (Physical),Myra Bairstow-Obi (Vice President),...
Agent:
The Farah Law Group,6550 St Augustine Rd SUITE 103, Jacksonville, FL 32217 (Physical)
EIN:
593129938
SIC:
8062 - General Medical and Surgical Hospitals
Company size:
3

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