Healthcare Provider Details

I. General information

NPI: 1063417285
Provider Name (Legal Business Name): LARGO ENDOSCOPY CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 BRYAN DAIRY ROAD SUITE 495
LARGO FL
33777
US

IV. Provider business mailing address

7300 BRYAN DAIRY ROAD SUITE 495
LARGO FL
33777
US

V. Phone/Fax

Practice location:
  • Phone: 727-451-6780
  • Fax: 727-451-6799
Mailing address:
  • Phone: 727-451-6780
  • Fax: 727-451-6799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number1184
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number1184
License Number StateFL

VIII. Authorized Official

Name: NORA STRIFFOLINO
Title or Position: ADMINISTRATOR
Credential:
Phone: 727-451-6780