Provider Demographics
NPI:1689188823
Name:FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC
Entity Type:Organization
Organization Name:FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CHIEF EXECUTIVE OFFIC
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-670-3143
Mailing Address - Street 1:13060 TELECOM PARKWAY N
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0925
Mailing Address - Country:US
Mailing Address - Phone:813-972-4905
Mailing Address - Fax:813-558-6441
Practice Address - Street 1:5016 WEST CYPRESS STREET
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-3804
Practice Address - Country:US
Practice Address - Phone:813-542-2586
Practice Address - Fax:813-392-1975
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-27
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical