Provider Demographics
NPI:1578162228
Name:FLORIDA SURGICAL CARE LLC
Entity Type:Organization
Organization Name:FLORIDA SURGICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IHOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PIDHORECKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-372-1429
Mailing Address - Street 1:2301 N UNIVERSITY DR STE 204
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3617
Mailing Address - Country:US
Mailing Address - Phone:954-372-1429
Mailing Address - Fax:954-744-4519
Practice Address - Street 1:2301 N UNIVERSITY DR STE 204
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3617
Practice Address - Country:US
Practice Address - Phone:954-372-1429
Practice Address - Fax:954-744-4519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty