Provider Demographics
NPI:1326435926
Name:SELECT PHYSICIANS SURGERY CENTERS
Entity Type:Organization
Organization Name:SELECT PHYSICIANS SURGERY CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:RAMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-329-2882
Mailing Address - Street 1:3440 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6214
Mailing Address - Country:US
Mailing Address - Phone:813-321-1618
Mailing Address - Fax:813-559-8216
Practice Address - Street 1:3440 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6214
Practice Address - Country:US
Practice Address - Phone:813-321-1618
Practice Address - Fax:813-559-8216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical