Organization
ST MARY SURGICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMGED GAMIL YOUNAN (SURGICAL ASSISTANT CERTIFIED SA-C)
(727) 417-2151
Entity
Organization
Contact information
Practice address
5343 59TH CIRCLE WEST, KENNETH CITY, FL 33709
(727) 417-2151
Mailing address
P.O.BOX 14101, CLEARWATER, FL 33766-4101
(727) 417-2151
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
SA-C # 05-254
FL
Other
Enumeration date
05/23/2007
Last updated
08/22/2020
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