Provider Demographics
NPI:1114980166
Name:NEW PORT RICHEY SURGERY CENTER LTD
Entity Type:Organization
Organization Name:NEW PORT RICHEY SURGERY CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:SWINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-789-2877
Mailing Address - Street 1:9332 STATE ROAD 54
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1810
Mailing Address - Country:US
Mailing Address - Phone:727-848-0446
Mailing Address - Fax:727-842-3166
Practice Address - Street 1:9332 STATE ROAD 54
Practice Address - Street 2:SUITE 100
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1810
Practice Address - Country:US
Practice Address - Phone:727-848-0446
Practice Address - Fax:727-842-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL958261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL079039700Medicaid
FLF1013Medicare PIN