Provider Demographics
NPI:1144382284
Name:PASADENA SURGERY CENTER LLC
Entity Type:Organization
Organization Name:PASADENA SURGERY CENTER LLC
Other - Org Name:PASADENA SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-302-9200
Mailing Address - Street 1:6945 FIRST AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1210
Mailing Address - Country:US
Mailing Address - Phone:727-302-9200
Mailing Address - Fax:727-302-9227
Practice Address - Street 1:6945 FIRST AVE SO
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1210
Practice Address - Country:US
Practice Address - Phone:727-302-9200
Practice Address - Fax:727-302-9227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1268261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical