Provider Demographics
NPI:1942749114
Name:DUNEDIN SURGICAL CONSULTANTS, LLC
Entity Type:Organization
Organization Name:DUNEDIN SURGICAL CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:FRIEND
Authorized Official - Last Name:AUD
Authorized Official - Suffix:
Authorized Official - Credentials:CPC-A
Authorized Official - Phone:727-849-1309
Mailing Address - Street 1:6710 EMBASSY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-7754
Mailing Address - Country:US
Mailing Address - Phone:727-849-1309
Mailing Address - Fax:727-245-8661
Practice Address - Street 1:3129 ALTERNATE 19
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-1503
Practice Address - Country:US
Practice Address - Phone:727-849-1309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center