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General NPI Number Information
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NPI Number | 1720911316
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Entity Type | Organization
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Legal Business Name | TAMPA BAY SURGERY CENTER MIDTOWN LLC
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 2727 W DR MLK BLVD STE 150
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City | TAMPA
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State | FL
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Zip | 33607-6003
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Country | US
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Telephone | 813-961-8500
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Fax | 831-265-2564
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Provider Business Mailing Address
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Address Line | 2727 W DR MLK BLVD STE 150
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City | TAMPA
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State | FL
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Zip | 33607-6003
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Country | US
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Telephone | 813-961-8500
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Fax | 831-265-2564
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Authorized Official
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Title or Position | REGIONAL VICE PRESIDENT OPERATIONS
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Name | JACK ELLIS
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Credential |
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Telephone | 763-464-9779
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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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