MEDICARE: SUNCOAST SPECIALTY SURGERY CENTER, LLLP

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
1	261QA1903X	Ambulatory Surgical Clinic/Center	PENDING	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1386681161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNCOAST SPECIALTY SURGERY CENTER, LLLP

Provider Business Mailing Address
First Line	:	4519 US HIGHWAY 19
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4941
Country	:	US
Telephone Number	:	727-847-0889
Fax Number	:	727-846-8458

Provider Business Practice Location Address
First Line	:	4519 US HIGHWAY 19
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4941
Country	:	US
Telephone Number	:	727-847-0889
Fax Number	:	727-846-8458

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CAREY THOMAS ROWAN
Credential	:	M.D.
Telephone Number	:	727-847-0889

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/22/2020

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