Organization
ORTHOPAEDIC SURGERY CENTER OF CLEARWATER LLC
Active
Other names
Orthopaedic Surgery Center of Clearwater
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL SMITH RN (DIRECTOR OF NURSING)
(727) 448-0822
Entity
Organization
Contact information
Practice address
402 JEFFORDS STREET, CLEARWATER, FL 33756
(727) 448-0822
(727) 447-7044
Mailing address
402 JEFFORDS STREET, CLEARWATER, FL 33756
(727) 448-0822
(727) 447-7044
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1122
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075143000
—
FL
01
—
1122
STATE LIC.
FL
01
—
2602599
AETNA HMO
FL
01
—
490005251
RAILROAD MEDICARE
FL
01
—
69H
BCBS
FL
01
—
7544268
AETNA PPO
FL
Enumeration date
10/25/2006
Last updated
04/30/2012
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