Provider Demographics
NPI:1790736502
Name:SEVEN HILLS SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:SEVEN HILLS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-552-0608
Mailing Address - Street 1:2010 FLEISCHMANN RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4599
Mailing Address - Country:US
Mailing Address - Phone:850-552-0608
Mailing Address - Fax:850-552-0925
Practice Address - Street 1:2010 FLEISCHMANN RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4599
Practice Address - Country:US
Practice Address - Phone:850-552-0608
Practice Address - Fax:850-552-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1240261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6L6OtherFL BCBS PROVIDER ID
FL076139700Medicaid
FL076139700Medicaid