Organization Active NPI

South Tampa Surgery Center, LLC.

  • Ambulatory Surgical Clinic/Center
  • Tampa, FL
National Provider Identifier
1124186663
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SOUTH TAMPA SURGERY CENTER, LLC.
Practice address
3600 W Kennedy Blvd
Tampa, FL 33609-2802
Phone
(813) 873-8700
Fax
(813) 873-0101
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stanley Robert Dennison Jr., MDNPI 1376618470
Title
President
Phone
(813) 873-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3600 W Kennedy Blvd
Tampa, FL 33609-2802

Mailing address

3600 W Kennedy Blvd
Tampa, FL 33609-2802
Phone (813) 873-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111213000247 FL Part B Supplier - Ambulatory Surgical Center 1355516881 Receives reassigned benefits from 4 practitioners
Practice locations: Tampa, FL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
South Tampa Surgery Center LLCCCN 10C0001403
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1009075South Tampa Surgery Center3600 W Kennedy Blvd, Tampa, FL 33609Certificate of waiverFeb 4, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3600 W Kennedy Blvd
Tampa, FL 33609
Phone (813) 873-8700

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1124186663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W KENNEDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092802",
            "telephone_number": "813-873-8700",
            "fax_number": "813-873-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W KENNEDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092802",
            "telephone_number": "813-873-8700",
            "fax_number": "813-873-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TAMPA SURGERY CENTER, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "DENNISON",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-873-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.