Provider Demographics
NPI:1801839691
Name:SURGICAL ASSOCIATES OF WEST FL
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF WEST FL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:JEFFERY
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-712-3233
Mailing Address - Street 1:1840 MEASE DRIVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-6605
Mailing Address - Country:US
Mailing Address - Phone:727-712-3233
Mailing Address - Fax:727-712-1853
Practice Address - Street 1:1840 MEASE DRIVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6605
Practice Address - Country:US
Practice Address - Phone:727-712-3233
Practice Address - Fax:727-712-1853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33975Medicare PIN