Provider Demographics
NPI:1285010785
Name:JOHN DRYGAS LLC
Entity Type:Organization
Organization Name:JOHN DRYGAS LLC
Other - Org Name:INFINITY NEUROSURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRYGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-432-3959
Mailing Address - Street 1:900 CARILLON PKWY
Mailing Address - Street 2:SUITE 402A
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1115
Mailing Address - Country:US
Mailing Address - Phone:727-432-3959
Mailing Address - Fax:
Practice Address - Street 1:900 CARILLON PKWY
Practice Address - Street 2:SUITE 402A
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1115
Practice Address - Country:US
Practice Address - Phone:727-432-3959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty