1750333746 NPI number — NORTH PINELLAS SURGERY CENTER LLC

Table of content: (NPI 1750333746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750333746 NPI number — NORTH PINELLAS SURGERY CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH PINELLAS SURGERY CENTER LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750333746
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2323 CURLEW RD
Provider Second Line Business Mailing Address:
BUILDING 5
Provider Business Mailing Address City Name:
DUNDEIN
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34698-9307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-771-8333
Provider Business Mailing Address Fax Number:
727-771-8844

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2323 CURLEW RD
Provider Second Line Business Practice Location Address:
BUILDING 5
Provider Business Practice Location Address City Name:
DUNDEIN
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34698-9307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-771-8333
Provider Business Practice Location Address Fax Number:
727-771-8844
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEIGLE
Authorized Official First Name:
DEBBIE
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR CFO
Authorized Official Telephone Number:
727-771-8333

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6800333 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 075258400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200768 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 94944591 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7494346 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 69Y . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 075258400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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