Provider Demographics
NPI:1093766735
Name:TAMPA BAY SURGERY CENTER ASSOCIATES,LTD
Entity Type:Organization
Organization Name:TAMPA BAY SURGERY CENTER ASSOCIATES,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-961-8500
Mailing Address - Street 1:11811 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3505
Mailing Address - Country:US
Mailing Address - Phone:813-961-8500
Mailing Address - Fax:813-265-2564
Practice Address - Street 1:11811 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3505
Practice Address - Country:US
Practice Address - Phone:813-961-8500
Practice Address - Fax:813-265-2564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL907261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF1166Medicare ID - Type Unspecified