Organization
ST. PETERSBURG ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHETAN K DESAI MD (PRESIDENT)
(727) 820-7500
Entity
Organization
Contact information
Practice address
560 JACKSON STREET NORTH, SUITE 200, ST. PETERSBURG, FL 33705-1449
(727) 820-7500
(727) 820-6333
Mailing address
560 JACKSON STREET NORTH, SUITE 200, ST. PETERSBURG, FL 33705-1449
(727) 820-7500
(727) 820-6333
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
1247
FL
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
14960618
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076202400
—
FL
Enumeration date
08/03/2006
Last updated
09/25/2012
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