MEDICARE: THE SURGERY CENTER AT TGH BRANDON HEALTHPLEX 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962953018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SURGERY CENTER AT TGH BRANDON HEALTHPLEX LLC

Provider Business Mailing Address
First Line	:	10740 PALM RIVER RD
Second Line	:	STE 210
City	:	TAMPA
State	:	FL
Zip	:	33619-4572
Country	:	US
Telephone Number	:	813-660-6600
Fax Number	:

Provider Business Practice Location Address
First Line	:	10740 PALM RIVER RD
Second Line	:	STE 210
City	:	TAMPA
State	:	FL
Zip	:	33619-4572
Country	:	US
Telephone Number	:	813-660-6600
Fax Number	:

Authorized Official
Title or Position	:	EVP CHIEF AMBULATORY OFFICER
Name	:	ADAM SMITH
Credential	:
Telephone Number	:	813-844-8034

Provider Enumeration Date	:	10/24/2016
Last Update Date	:	12/24/2025

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