Organization
PHYSICIANS PROFESSIONAL ALLIANCE, LLC
Active
Parent organization
SUNCOAST SURGICAL ASSOCIATES P A
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNCOAST SURGICAL ASSOCIATES P A
Authorized official
DR. GOPAL S GRANDHIGE MD (TREASURER)
(813) 684-6006
Entity
Organization
Contact information
Practice address
519 MEDICAL OAKS AVE, BRANDON, FL 33511-5961
(813) 685-7995
(813) 685-8802
Mailing address
519 MEDICAL OAKS AVE, BRANDON, FL 33511-5961
(813) 685-7995
(813) 685-8802
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
06/25/2020
Last updated
07/06/2020
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