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266700081915APPLICATION CHECKLIST Health Care Licensing Application AMBULATORY SURGICAL CENTER 00APPLICATION CHECKLIST Health Care Licensing Application
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Document Date: 2014-09-23 11:13:51


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City

Tallahassee / /

Company

The Agency for Health Care Administration / Agency for Persons / State Limited Liability Company / Agency for Health Care Administration Case / TITLE NAME TELEPHONE NUMBER E-MAIL / F.S. Laboratory / Religious Affiliation City/County Partnership / Profit Public Corporation Corporation / AGENCY FOR HEALTH CARE ADMINISTRATION HOSPITAL / /

Currency

USD / /

Facility

facility Change / Hospital Address / /

IndustryTerm

insurance fraud / renewal applications / ownership applications / /

MedicalCondition

MS / /

Organization

Department of State / Department of Financial Services / American Osteopathic Association / American Association for Accreditation of Ambulatory Surgery Facilities / State Division of Corporations / Licensee AUTHORITY / officers of Licensee / Ambulatory Surgical Center / Bureau of Plans and Construction / Outpatient Services Unit / 266700081915APPLICATION CHECKLIST Health Care Licensing Application AMBULATORY SURGICAL CENTER 00APPLICATION CHECKLIST Health Care Licensing Application AMBULATORY SURGICAL CENTER / Department of Health / Accreditation Association for Ambulatory Health Care / Division of Corporations / Medicare / /

/

Position

Financial Officer / board member / General Information Bed Capacity Number / Patient Safety Officer / Risk Manager / President / Vice President / Administrator and Financial Officer / Administrator / Financial Officer / Risk Manager / Administrator / Treasurer / Representative / Proprietor / Secretary / officer / Florida Secretary / Director BUSINESS ADDRESS TELEPHONE NUMBER /CEO / Administrative Contractor / /

Product

Form 3110-1024 / /

ProgrammingLanguage

FL / /

ProvinceOrState

Florida / /

Technology

X-ray / /

URL

http /

SocialTag