Provider Demographics
NPI:1962953018
Name:THE SURGERY CENTER AT TGH BRANDON HEALTHPLEX LLC
Entity type:Organization
Organization Name:THE SURGERY CENTER AT TGH BRANDON HEALTHPLEX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP CHIEF AMBULATORY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-844-8034
Mailing Address - Street 1:10740 PALM RIVER RD
Mailing Address - Street 2:STE 210
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4572
Mailing Address - Country:US
Mailing Address - Phone:813-660-6600
Mailing Address - Fax:
Practice Address - Street 1:10740 PALM RIVER RD
Practice Address - Street 2:STE 210
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4572
Practice Address - Country:US
Practice Address - Phone:813-660-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical