MEDICARE: MANSFIELD SURGICAL PLAZA 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
1	261QA1903X	Ambulatory Surgical Clinic/Center	008706	TX

General Provider Information

NPI Number	:	1790945145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANSFIELD SURGICAL PLAZA LLC

Provider Business Mailing Address
First Line	:	280 REGENCY PKWY
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-7823
Country	:	US
Telephone Number	:	817-453-2744
Fax Number	:	817-842-0007

Provider Business Practice Location Address
First Line	:	280 REGENCY PKWY
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-7823
Country	:	US
Telephone Number	:	817-453-2744
Fax Number	:	817-842-0007

Authorized Official
Title or Position	:	CEO
Name	:	SHAWN SOLITO
Credential	:
Telephone Number	:	817-453-2744

Provider Enumeration Date	:	06/10/2008
Last Update Date	:	02/17/2010

Similar Medicare Providers

1992037352 — BAYLOR SURGICARE AT MANSFIELD, LLC
Practice Location Address:

280 REGENCY PKWY
MANSFIELD, TX
76063-7823

Practice Phone: 817-453-2744
Practice Fax: 817-842-0007

1992188510 — MANSFIELD ANESTHESIA CONSULTANTS PLLC
Practice Location Address:

280 REGENCY PKWY
MANSFIELD, TX
76063-7823

Practice Phone: 817-405-9591
Practice Fax:

1043892102 — DURGA ANESTHESIA PLLC
Practice Location Address:

280 REGENCY PKWY
MANSFIELD, TX
76063-7823

Practice Phone: 765-284-0493
Practice Fax:

1194689067 — ROWAN GEALICHUAIN
Practice Location Address:

3044 N MAIN ST
MANSFIELD, OH
44903-7823

Practice Phone: 567-307-5173
Practice Fax:

1851942254 — MISTY J KLINE
Practice Location Address:

3018 N MAIN ST
MANSFIELD, OH
44903-7823

Practice Phone: 419-677-1201
Practice Fax:

1821439274 — NADEEN LUCERO SOEDERBAUM M.D.
Practice Location Address:

221 REGENCY PKWY , STE 125
MANSFIELD, TX
76063-5379

Practice Phone: 817-477-5884
Practice Fax: 855-620-7823

Directions to “MANSFIELD SURGICAL PLAZA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.