Organization
FKP TAMPA AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN ELLENBURG (CHIEF OF PROVIDER GROUP OPERATIONS)
(480) 421-8745
Entity
Organization
Contact information
Practice address
514 EICHENFELD DR, BRANDON, FL 33511-5955
(813) 358-1568
(813) 200-1840
Mailing address
1 PARKWAY NORTH BLVD STE 200S, DEERFIELD, IL 60015-2534
(847) 388-2064
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
08/20/2025
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