MEDICARE: TAMPA BAY SURGERY CENTER ASSOCIATES LTD

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

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	:	1538664644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA BAY SURGERY CENTER ASSOCIATES LTD

Provider Business Mailing Address
First Line	:	11811 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-3505
Country	:	US
Telephone Number	:	813-357-5915
Fax Number	:	813-902-7307

Provider Business Practice Location Address
First Line	:	11911 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-3507
Country	:	US
Telephone Number	:	813-961-8500
Fax Number	:	813-902-7307

Authorized Official
Title or Position	:	INSURANCE COORDINATOR
Name	:	MRS. ELIZABETH ANN NORMAN
Credential	:
Telephone Number	:	813-961-8500

Provider Enumeration Date	:	03/29/2018
Last Update Date	:	03/11/2019

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