Healthcare Provider Details

I. General information

NPI: 1922949965
Provider Name (Legal Business Name): MIDTOWN TAMPA ASC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 MARTIN LUTHER KING BLVD STE 150
TAMPA FL
33607
US

IV. Provider business mailing address

4140 PARKLAKE DRIVE
RALEIGH NC
27612-3723
US

V. Phone/Fax

Practice location:
  • Phone: 813-961-8500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH RITTMAN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 919-924-4455