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Organization

ST MICHAELS SURGERY CENTER INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN L MICHAELOS M.D. (OWNER)
(727) 585-2200
Entity
Organization

Contact information

Practice address
1018 W BAY DR, LARGO, FL 33770-3225
(727) 585-2200
(727) 584-9239
Mailing address
1030 W BAY DR STE 200, LARGO, FL 33770-3276
(727) 585-2200
(813) 697-1758

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1118
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
070826700
FL
01
50101269
AETNA PROVIDER ID
FL
01
69K
BCBS PROVIDER ID
FL
Enumeration date
03/31/2006
Last updated
11/13/2024
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