Organization
ARMENIA AMBULATORY SURGERY CENTER LLC
Active
Other names
Medical Village Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (AUTHORIZED OFFICIAL)
(615) 234-5900
Entity
Organization
Contact information
Practice address
2333 W HILLSBOROUGH AVE STE 120, TAMPA, FL 33603-1052
(813) 871-9032
(813) 870-9543
Mailing address
2333 W HILLSBOROUGH AVE STE 120, TAMPA, FL 33603-1052
(813) 871-9032
(813) 870-9543
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1094
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070425300
—
FL
01
—
68H
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/11/2006
Last updated
12/17/2018
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