1831254168 NPI number — ALL CHILDREN'S SURGIKID OF FLORIDA, INC

Table of content: (NPI 1831254168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831254168 NPI number — ALL CHILDREN'S SURGIKID OF FLORIDA, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL CHILDREN'S SURGIKID OF FLORIDA, INC
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:
SURGIKID OF FLORIDA, INC
Provider Other Organization Name Type Code:
4
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:
1831254168
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 6TH AVE S
Provider Second Line Business Mailing Address:
DEPT. #9525
Provider Business Mailing Address City Name:
ST PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33701-4634
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-898-7451
Provider Business Mailing Address Fax Number:
727-767-4191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 6TH AVE S
Provider Second Line Business Practice Location Address:
DEPT. #9525
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33701-4634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-898-7451
Provider Business Practice Location Address Fax Number:
727-767-4191
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALESSI
Authorized Official First Name:
ROBERTA
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT & COO
Authorized Official Telephone Number:
727-767-2868

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  1048 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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