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General NPI Number Information
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NPI Number | 1720033293
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Entity Type | Organization
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Legal Business Name | CLINIC SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 2407 CYPRESS RIDGE BOULEVARD
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-0004
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Country | US
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Telephone | 813-991-7575
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Fax | 813-335-5085
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Provider Business Mailing Address
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Address Line | 2407 CYPRESS RIDGE BOULEVARD
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-0004
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Country | US
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Telephone | 813-991-7575
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Fax | 813-335-5085
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Authorized Official
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Title or Position | PRESIDENT/BOARD MEMBER OF CLINIC SU
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Name | GREGORY P OHE
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Credential |
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Telephone | 321-843-2355
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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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