Provider Demographics
NPI:1477722841
Name:SURGICAL CONSULTANTS OF CENTRAL FL
Entity Type:Organization
Organization Name:SURGICAL CONSULTANTS OF CENTRAL FL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:O
Authorized Official - Last Name:ORAEDU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-690-6000
Mailing Address - Street 1:PO BOX 6195
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478
Mailing Address - Country:US
Mailing Address - Phone:352-690-6000
Mailing Address - Fax:352-690-6643
Practice Address - Street 1:1329 SE 25TH LOOP
Practice Address - Street 2:SUITE 102
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-690-6000
Practice Address - Fax:352-690-6643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85455208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6094Medicare UPIN