Provider Demographics
NPI:1508822685
Name:BRADENTON SURGERY CENTER INC
Entity Type:Organization
Organization Name:BRADENTON SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALPHONSO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELSITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-792-1430
Mailing Address - Street 1:2902 59TH ST W
Mailing Address - Street 2:SUITES F & G
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7023
Mailing Address - Country:US
Mailing Address - Phone:941-792-9685
Mailing Address - Fax:941-757-1377
Practice Address - Street 1:2902 59TH ST W
Practice Address - Street 2:SUITES F & G
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7023
Practice Address - Country:US
Practice Address - Phone:941-792-9685
Practice Address - Fax:941-757-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF1242Medicare ID - Type Unspecified