Provider Demographics
NPI:1417949280
Name:CLEARWATER AMBULATORY SURGICAL CENTERS INC
Entity Type:Organization
Organization Name:CLEARWATER AMBULATORY SURGICAL CENTERS INC
Other - Org Name:CLEARWATER ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-443-0100
Mailing Address - Street 1:401 CORBETT ST
Mailing Address - Street 2:STE 220
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-7309
Mailing Address - Country:US
Mailing Address - Phone:727-443-0100
Mailing Address - Fax:727-461-4893
Practice Address - Street 1:401 CORBETT ST
Practice Address - Street 2:STE 220
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-7309
Practice Address - Country:US
Practice Address - Phone:727-443-0100
Practice Address - Fax:727-461-4893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL925261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6805119OtherUNITED HEALTHCARE
FL1044849OtherAETNA PROVIDER #
FL62HOtherBCBS FL PROVIDER#
FL6805119OtherUNITED HEALTHCARE
FLF1169Medicare ID - Type UnspecifiedMEDICARE PROVIDER #