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NPI Code Detail

MEDICARE: FLORIDA SURGERY CENTER ENTERPRISES LLC

MEDICARE: FLORIDA SURGERY CENTER ENTERPRISES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center942FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111115401OTHERFLCITRUS CARE
217348OTHERFLWELLCARE/STAYWELL
317348OTHERFLHEALTHEASE
4215471OTHERFLAMERIGROUP
5626273OTHERFLAETNA
660XOTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1316973050
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA SURGERY CENTER ENTERPRISES LLC
Provider Business Mailing Address
First Line : 5013 N ARMENIA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33603-1403
Country : US
Telephone Number : 813-875-0562
Fax Number : 813-871-5236
Provider Business Practice Location Address
First Line : 5013 N ARMENIA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33603-1403
Country : US
Telephone Number : 813-875-0562
Fax Number : 813-871-5236
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. MAUREEN F. MARTIN
Credential : RN
Telephone Number : 813-844-4434
Provider Enumeration Date : 06/24/2006
Last Update Date : 07/25/2007

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Directions to “FLORIDA SURGERY CENTER ENTERPRISES LLC ” Practice Location

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