Organization
LARGO SURGERY LLC
Active
Other names
West Bay Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED)
(615) 234-5954
Entity
Organization
Contact information
Practice address
1401 W BAY DR, LARGO, FL 33770-2207
(727) 585-9500
(727) 584-1938
Mailing address
1401 W BAY DR, LARGO, FL 33770-2207
(727) 585-9500
(727) 584-1938
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
781
FL
291U00000X
Clinical Medical Laboratory
800005342
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070644200
—
FL
01
—
0771519008
CIGNA
—
01
—
691
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
06/21/2005
Last updated
06/26/2023
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