FKP TAMPA AMBULATORY SURGERY CENTER LLC NPI 1205600806

NPI Information

NPI: 1205600806
Provider Name: FKP TAMPA AMBULATORY SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D2298801

Address:
514 EICHENFELD DR
BRANDON, FL
ZIP 33511
Phone: (813) 358-1568
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FKP TAMPA AMBULATORY SURGERY CENTER, LLC is an ambulatory surgical clinic center in Brandon, FL. FKP TAMPA AMBULATORY SURGERY CENTER, LLC NPI is 1205600806. The provider is registered as an organization entity type.

The provider's business location address is:

514 EICHENFELD DR
BRANDON, FL
ZIP 33511-955
Phone: (813) 358-1568
Fax: (813) 200-1840

The provider's authorized official is Tim Bogardus .
The authorized official title is Administrator and has the following contact phone number (602) 638-3180.

The CLIA number assigned to this NPI record is 10D2298801 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2023 and was last updated on 1/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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