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General NPI Number Information
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NPI Number | 1740168574
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Entity Type | Organization
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Legal Business Name | TAMPA BAY COSMETIC SURGERY CENTER LLC
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 6025 4TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33703-1419
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Country | US
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Telephone | 727-522-3223
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Fax | 727-521-0500
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Provider Business Mailing Address
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Address Line | 6025 4TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33703-1419
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Country | US
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Telephone | 727-522-3223
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Fax | 727-521-0500
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Authorized Official
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Title or Position | OWNER
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Name | LAWRENCE G KASS
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Credential | MD
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Telephone | 727-522-3223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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