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Organization
LARGO SURGERY LLC
Active
Organization
LARGO SURGERY LLC
Active
Other names
West Bay Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED)
(615) 234-5954
Entity
Organization
Contact information
Practice address
1401 W BAY DR, LARGO, FL 33770-2207
(727) 585-9500
(727) 584-1938
Mailing address
1401 W BAY DR, LARGO, FL 33770-2207
(727) 585-9500
(727) 584-1938
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
781
FL
291U00000X
Clinical Medical Laboratory
800005342
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070644200
—
FL
01
—
0771519008
CIGNA
—
01
—
691
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
06/21/2005
Last updated
06/26/2023
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