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General NPI Number Information
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NPI Number | 1508879446
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Entity Type | Organization
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Legal Business Name | WEST FLORIDA SURGERY CENTER INC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 5817 21ST AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-5641
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Country | US
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Telephone | 941-794-0379
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Fax | 941-798-9905
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Provider Business Mailing Address
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Address Line | 5817 21ST AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-5641
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Country | US
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Telephone | 941-794-0379
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Fax | 941-798-9905
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE W TROTMAN
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Credential | MD
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Telephone | 941-794-0379
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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
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License Number | 960
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License Number State | FL
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