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General NPI Number Information
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NPI Number | 1932550373
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Entity Type | Organization
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Legal Business Name | FLORIDA SURGICAL CLINIC LLC
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 701 MANATEE AVE W SUITE 105
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City | BRADENTON
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State | FL
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Zip | 34205-8604
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Country | US
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Telephone | 941-592-9240
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Fax |
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Provider Business Mailing Address
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Address Line | 701 MANATEE AVE W SUITE 105
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City | BRADENTON
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State | FL
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Zip | 34205-8604
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PETER KAZIL
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Credential |
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Telephone | 941-592-9240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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