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Organization
ARMENIA AMBULATORY SURGERY CENTER LLC
Active
Organization
ARMENIA AMBULATORY SURGERY CENTER LLC
Active
Other names
Medical Village Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (AUTHORIZED OFFICIAL)
(615) 234-5900
Entity
Organization
Contact information
Practice address
2333 W HILLSBOROUGH AVE STE 120, TAMPA, FL 33603-1052
(813) 871-9032
(813) 870-9543
Mailing address
2333 W HILLSBOROUGH AVE STE 120, TAMPA, FL 33603-1052
(813) 871-9032
(813) 870-9543
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1094
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070425300
—
FL
01
—
68H
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/11/2006
Last updated
12/17/2018
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