Provider Demographics
NPI:1417490509
Name:ABSOLUTE SURGICAL SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:ABSOLUTE SURGICAL SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:AMSHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-633-0081
Mailing Address - Street 1:139 S PEBBLE BEACH BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5799
Mailing Address - Country:US
Mailing Address - Phone:813-633-0081
Mailing Address - Fax:813-633-0082
Practice Address - Street 1:139 S PEBBLE BEACH BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5799
Practice Address - Country:US
Practice Address - Phone:813-633-0081
Practice Address - Fax:813-633-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90042208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2711940-00Medicaid
FL48129YOtherMEDICARE INDIVIDUAL
FLI19789Medicare UPIN