Provider Demographics
NPI:1063417285
Name:LARGO ENDOSCOPY CENTER LP
Entity type:Organization
Organization Name:LARGO ENDOSCOPY CENTER LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRIFFOLINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-451-6780
Mailing Address - Street 1:7300 BRYAN DAIRY ROAD
Mailing Address - Street 2:SUITE 495
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777
Mailing Address - Country:US
Mailing Address - Phone:727-451-6780
Mailing Address - Fax:727-451-6799
Practice Address - Street 1:7300 BRYAN DAIRY ROAD
Practice Address - Street 2:SUITE 495
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777
Practice Address - Country:US
Practice Address - Phone:727-451-6780
Practice Address - Fax:727-451-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1184207RG0100X, 261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1184OtherAMBULATORY SURGERY CENTER
FLF1405Medicare UPIN