Provider Demographics
NPI:1508879446
Name:WEST FLORIDA SURGERY CENTER INC
Entity Type:Organization
Organization Name:WEST FLORIDA SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIMANTAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALEPUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-761-1800
Mailing Address - Street 1:5817 21ST AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5641
Mailing Address - Country:US
Mailing Address - Phone:941-794-0379
Mailing Address - Fax:941-798-9905
Practice Address - Street 1:5817 21ST AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5641
Practice Address - Country:US
Practice Address - Phone:941-794-0379
Practice Address - Fax:941-798-9905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL960261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
612OtherBCBS OF FL
FL00000002OtherAHCA
612OtherBCBS OF FL