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General NPI Number Information
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NPI Number | 1114055142
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Entity Type | Organization
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Legal Business Name | ADVANCED HAND AND PLASTIC SURGERY CENTER LLC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 2318 GREENBRANCH DR SUITE 101-102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6797
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Country | US
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Telephone | 813-866-4426
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Fax | 813-972-8866
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Provider Business Mailing Address
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Address Line | PO BOX 198551
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City | ATLANTA
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State | GA
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Zip | 30384-8551
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Country | US
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Telephone | 813-866-4426
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Fax | 813-972-8866
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT S GARGASZ
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Credential | MD
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Telephone | 813-866-4426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME93069
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License Number State | FL
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