Provider Demographics
NPI:1023189453
Name:MEADOW LANE SURGERY CENTER
Entity Type:Organization
Organization Name:MEADOW LANE SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHOVNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-847-7522
Mailing Address - Street 1:PO BOX 1090
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34656
Mailing Address - Country:US
Mailing Address - Phone:727-847-7522
Mailing Address - Fax:727-845-8912
Practice Address - Street 1:5652 MEADOW LANE
Practice Address - Street 2:SUITE A
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652
Practice Address - Country:US
Practice Address - Phone:727-847-7522
Practice Address - Fax:727-845-8912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1024261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL63BOtherBSFL
FL63BOtherBSFL