Provider Demographics
NPI:1376580498
Name:SAME DAY SURGERY CENTERS OF FLORIDA LLC
Entity Type:Organization
Organization Name:SAME DAY SURGERY CENTERS OF FLORIDA LLC
Other - Org Name:SAME DAY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHOOTCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-783-8242
Mailing Address - Street 1:6733 GALL BLVD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-2519
Mailing Address - Country:US
Mailing Address - Phone:813-783-8242
Mailing Address - Fax:813-783-8240
Practice Address - Street 1:6733 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2519
Practice Address - Country:US
Practice Address - Phone:813-783-8242
Practice Address - Fax:813-783-8240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL60ZOtherBCBS
FL026267200Medicaid
FLF1501Medicare PIN