Provider Demographics
NPI:1891172078
Name:COMPREHENSIVE SURGERY CENTER LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:RADEMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:727-953-8090
Mailing Address - Street 1:1988 GULF TO BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3550
Mailing Address - Country:US
Mailing Address - Phone:727-953-8090
Mailing Address - Fax:727-953-8088
Practice Address - Street 1:407 AURORA AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765
Practice Address - Country:US
Practice Address - Phone:727-953-8090
Practice Address - Fax:727-953-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical