Provider Demographics
NPI:1336481555
Name:STRONG SURGICAL ENTERPRISES, LLC
Entity Type:Organization
Organization Name:STRONG SURGICAL ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:813-447-0015
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-0777
Mailing Address - Country:US
Mailing Address - Phone:727-754-6186
Mailing Address - Fax:727-754-6137
Practice Address - Street 1:1125 PELICAN PL
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-5022
Practice Address - Country:US
Practice Address - Phone:727-754-6186
Practice Address - Fax:727-754-6137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA1597363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS58974Medicare UPIN