COUNTRYSIDE SURGERY CENTER LTD NPI 1518920040

NPI Information

NPI: 1518920040
Provider Name: COUNTRYSIDE SURGERY CENTER, LTD
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D0721298

Address:
3291 N MCMULLEN BOOTH RD
CLEARWATER, FL
ZIP 33761
Phone: (727) 725-5800
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COUNTRYSIDE SURGERY CENTER, LTD is an ambulatory surgical clinic center in Clearwater, FL. COUNTRYSIDE SURGERY CENTER, LTD NPI is 1518920040. The provider is registered as an organization entity type.

The provider's business location address is:

3291 N MCMULLEN BOOTH RD
CLEARWATER, FL
ZIP 33761-010
Phone: (727) 725-5800
Fax: (727) 797-4002

The provider's authorized official is William G Swinney .
The authorized official title is Vp and has the following contact phone number (972) 789-2877.

The CLIA number assigned to this NPI record is 10D0721298 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2006 and was last updated on 2/6/2018.

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	986	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	079131800	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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