Provider Demographics
NPI:1841605318
Name:FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER, LLC
Other - Org Name:FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER-CITRUS PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:B
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MACC, CPA, CPC
Authorized Official - Phone:813-978-9700
Mailing Address - Street 1:13060 N TELECOM PKWY
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 1:6119 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4013
Practice Address - Country:US
Practice Address - Phone:813-972-4905
Practice Address - Fax:813-558-6441
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-24
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical