Organization Name:  LIVE OAK ENDOSCOPY CENTER, LLC


Practice Location:
275 18TH ST SUITE 101 VERO BEACH, FL 32960 US
Tel: 772-299-5005  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	FL	1154

Other Provider Identifiers:

Issuer	Number	State	Type
OXFORD HEALTH PLAN	A2882678		01
BC BS FLORIDA	6B6	FL	01
CIGNA	4677223		01
	075390400	FL	05
RAILROAD MEDICARE	490005670	FL	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin