Organization
OSCEOLA SURGICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARK RODKEY (VP)
(850) 523-2117
Entity
Organization
Contact information
Practice address
320 W BASS ST, KISSIMMEE, FL 34741-5001
(407) 870-0808
(407) 846-9115
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 372-5426
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000352300
—
FL
05
—
047675700
—
FL
01
—
P00674127 GRP#D0365
RAILROAD MEDICARE
FL
Enumeration date
06/13/2008
Last updated
05/16/2024
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