Provider Demographics
NPI:1225426513
Name:ASC OF TAMPABAY
Entity Type:Organization
Organization Name:ASC OF TAMPABAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EREL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-400-4768
Mailing Address - Street 1:3129 ALT 19
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-1503
Mailing Address - Country:US
Mailing Address - Phone:727-400-4768
Mailing Address - Fax:727-408-5197
Practice Address - Street 1:3129 ALT 19
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-1503
Practice Address - Country:US
Practice Address - Phone:727-400-4768
Practice Address - Fax:727-408-5197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical