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NPI Code Detail

MEDICARE: PASADENA SURGERY CENTER LLC

MEDICARE: PASADENA SURGERY CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center1268FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144382284
Entity Type Code : Organization
Provider Name (Legal Business Name) : PASADENA SURGERY CENTER LLC
Provider Business Mailing Address
First Line : 6945 FIRST AVENUE SOUTH
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33707-1210
Country : US
Telephone Number : 727-302-9200
Fax Number : 727-302-9227
Provider Business Practice Location Address
First Line : 6945 FIRST AVE SO
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33707-1210
Country : US
Telephone Number : 727-302-9200
Fax Number : 727-302-9227
Authorized Official
Title or Position : PRESIDENT
Name : DR. DAVID EARL HALL
Credential : M.D.
Telephone Number : 727-302-9200
Provider Enumeration Date : 12/14/2006
Last Update Date : 08/22/2020

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Directions to “PASADENA SURGERY CENTER LLC ” Practice Location

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