Provider Demographics
NPI:1396842753
Name:SURGICAL SPECIALISTS OF CENTRAL FLORIDA INC
Entity type:Organization
Organization Name:SURGICAL SPECIALISTS OF CENTRAL FLORIDA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-293-5944
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:SUITE 495
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3436
Mailing Address - Country:US
Mailing Address - Phone:407-293-5944
Mailing Address - Fax:407-293-7355
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:SUITE 495
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3436
Practice Address - Country:US
Practice Address - Phone:407-293-5944
Practice Address - Fax:407-293-7355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME648032086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020050264OtherRAIL ROAD MEDICARE GROUP
FL74596OtherBCBS GROUP NUMBER
FL74596OtherBCBS GROUP NUMBER