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General NPI Number Information
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NPI Number | 1205946167
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Entity Type | Organization
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Legal Business Name | CARROLLWOOD SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/03/2010
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Provider Practice Location Address
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Address Line | 7171 N DALE MABRY HWY STE 402
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City | TAMPA
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State | FL
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Zip | 33614-2630
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Country | US
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Telephone | 813-933-3324
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Fax | 813-932-4357
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Provider Business Mailing Address
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Address Line | PO BOX 21727
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City | TAMPA
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State | FL
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Zip | 33622-1727
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Country | US
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Telephone | 813-933-3324
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Fax | 813-932-4357
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | SHARAD PATEL
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Credential | MD
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Telephone | 813-933-3324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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