Organization
TAMPA BAY SURGICAL GROUP LLP
Active
Parent organization
TAMPA BAY SURGICAL GROUP LLP
Organization subpart
Yes
Provider details
NPI number
Legal business name
TAMPA BAY SURGICAL GROUP LLP
Authorized official
JOHN A DIETRICK MD (PRESIDENT)
(813) 254-3016
Entity
Organization
Contact information
Practice address
606 S. BOULEVARD, TAMPA, FL 33606-2630
(813) 254-3016
(813) 254-3019
Mailing address
606 S. BOULEVARD, TAMPA, FL 33606-2630
(813) 254-3016
(813) 254-3019
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000210000
—
FL
Enumeration date
10/13/2015
Last updated
10/13/2015
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