Healthcare Provider Details

I. General information

NPI: 1033762588
Provider Name (Legal Business Name): ST LUKE'S AT THE VILLAGES BROWNWOOD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2019
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2955 BROWNWOOD BLVD
THE VILLAGES FL
32163
US

IV. Provider business mailing address

43309 US HIGHWAY 19 N
TARPON SPRINGS FL
34689-6221
US

V. Phone/Fax

Practice location:
  • Phone: 727-943-3111
  • Fax: 727-943-3334
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY MICHAEL ROSZEL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 727-938-2020