Provider Demographics
NPI:1689636755
Name:FLORIDA OBESITY SURGICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:FLORIDA OBESITY SURGICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GROSSBARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-788-5569
Mailing Address - Street 1:37840 MEDICAL ARTS CT
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-4325
Mailing Address - Country:US
Mailing Address - Phone:813-788-5569
Mailing Address - Fax:813-782-8628
Practice Address - Street 1:37840 MEDICAL ARTS CT
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-4325
Practice Address - Country:US
Practice Address - Phone:813-788-5569
Practice Address - Fax:813-782-8628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty