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Organization

OSCEOLA SURGICAL ASSOCIATES LLC

Active
Parent organization
OSCEOLA SURGICAL ASSOCIATES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
OSCEOLA SURGICAL ASSOCIATES LLC
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(615) 372-3375
Entity
Organization

Contact information

Practice address
720 W OAK ST STE 370, KISSIMMEE, FL 34741-4910
(407) 487-8333
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Enumeration date
10/08/2021
Last updated
10/08/2021
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