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General NPI Number Information
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NPI Number | 1326435926
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Entity Type | Organization
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Legal Business Name | SELECT PHYSICIANS SURGERY CENTERS
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 3440 W DR MARTIN LUTHER KING JR BLVD SUITE 103
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City | TAMPA
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State | FL
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Zip | 33607-6214
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Country | US
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Telephone | 813-321-1618
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Fax | 813-559-8216
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Provider Business Mailing Address
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Address Line | 3440 W DR MARTIN LUTHER KING JR BLVD SUITE 103
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City | TAMPA
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State | FL
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Zip | 33607-6214
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Country | US
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Telephone | 813-321-1618
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Fax | 813-559-8216
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Authorized Official
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Title or Position | MARKET PRESIDENT
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Name | MR. COLLIN LEMAISTRE
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Credential |
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Telephone | 214-213-0732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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