Provider Demographics
NPI:1750055356
Name:WEST COAST SURGICAL CENTER LLC
Entity type:Organization
Organization Name:WEST COAST SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAZI
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-548-6100
Mailing Address - Street 1:6333 54TH AVENUE NORTH
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-1703
Mailing Address - Country:US
Mailing Address - Phone:727-548-6100
Mailing Address - Fax:727-545-0960
Practice Address - Street 1:1330 S MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3530
Practice Address - Country:US
Practice Address - Phone:727-548-6100
Practice Address - Fax:727-497-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty