Provider Demographics
NPI:1043924574
Name:SURGICAL ASSOCIATES OF HERNANDO INC
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF HERNANDO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:POTDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-877-4749
Mailing Address - Street 1:17222 HOSPITAL BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-8925
Mailing Address - Country:US
Mailing Address - Phone:352-877-4749
Mailing Address - Fax:352-283-8697
Practice Address - Street 1:17222 HOSPITAL BLVD STE 116
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-8925
Practice Address - Country:US
Practice Address - Phone:352-877-4749
Practice Address - Fax:352-283-8697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty