Provider Demographics
NPI:1720337629
Name:TAMPA BAY SURGICAL LLC
Entity Type:Organization
Organization Name:TAMPA BAY SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:KINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-798-0024
Mailing Address - Street 1:5535 110TH AVE
Mailing Address - Street 2:UNIT 208
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782
Mailing Address - Country:US
Mailing Address - Phone:727-798-0024
Mailing Address - Fax:
Practice Address - Street 1:5535 110TH AVE
Practice Address - Street 2:UNIT 208
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782
Practice Address - Country:US
Practice Address - Phone:727-798-0024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty