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General NPI Number Information
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NPI Number | 1982788071
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC SURGERY CENTER OF CLEARWATER LLC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 04/30/2012
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Provider Practice Location Address
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Address Line | 402 JEFFORDS STREET
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City | CLEARWATER
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State | FL
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Zip | 33756
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Country | US
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Telephone | 727-448-0822
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Fax | 727-447-7044
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Provider Business Mailing Address
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Address Line | 402 JEFFORDS STREET
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City | CLEARWATER
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State | FL
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Zip | 33756
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Country | US
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Telephone | 727-448-0822
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Fax | 727-447-7044
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | DANIEL SMITH
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Credential | RN
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Telephone | 727-448-0822
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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 | 1122
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License Number State | FL
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