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Organization

OUTPATIENT SURGERY CENTER INC

Active
Parent organization
OUTPATIENT SURGERY CENTER INC
Other names
Brandon Outpatient Surgery Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
OUTPATIENT SURGERY CENTER INC
Authorized official
DR. GEORGE S. SIDHOM MD (MEDICAL DIRECTOR)
(813) 731-0416
Entity
Organization

Contact information

Practice address
201 NOLAND DRIVE, BRANDON, FL 33511-5728
(813) 684-7246
(302) 688-1113
Mailing address
PO BOX 10390, BROOKSVILLE, FL 34603-0390
(352) 688-6393
(352) 688-1113

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1157
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002639517
UNITEDHEALTH
FL
01
290429
STAYWELLWELLCARE
FL
Enumeration date
11/15/2006
Last updated
11/08/2012
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