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NPI Code Detail

MEDICARE: CLINIC SURGERY CENTER, LLC

MEDICARE: CLINIC 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/Center

General Provider Information

NPI Number : 1720033293
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINIC SURGERY CENTER, LLC
Provider Business Mailing Address
First Line : 2407 CYPRESS RIDGE BOULEVARD
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33544-0004
Country : US
Telephone Number : 813-991-7575
Fax Number : 813-335-5085
Provider Business Practice Location Address
First Line : 2407 CYPRESS RIDGE BOULEVARD
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33544-0004
Country : US
Telephone Number : 813-991-7575
Fax Number : 813-335-5085
Authorized Official
Title or Position : PRESIDENT/BOARD MEMBER OF CLINIC SU
Name : GREGORY P OHE
Credential :
Telephone Number : 321-843-2355
Provider Enumeration Date : 05/23/2006
Last Update Date : 05/03/2023

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Directions to “CLINIC SURGERY CENTER, LLC ” Practice Location

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