Provider Demographics
NPI:1346490315
Name:CITRUS PARK SURGERY CENTER
Entity Type:Organization
Organization Name:CITRUS PARK SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:NUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-864-3998
Mailing Address - Street 1:6322 GUNN HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4105
Mailing Address - Country:US
Mailing Address - Phone:813-864-3998
Mailing Address - Fax:
Practice Address - Street 1:6322 GUNN HWY
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4105
Practice Address - Country:US
Practice Address - Phone:813-864-3998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical