FKP Tampa Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FKP TAMPA AMBULATORY SURGERY CENTER, LLC

Practice address

514 Eichenfeld Dr
Brandon, FL 33511-5955

Phone

(813) 358-1568

Fax

(813) 200-1840

NPI assigned

Nov 14, 2023

Last updated

Aug 20, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauren Ellenburg

Title

Chief of Provider Group Operations

Phone

(480) 421-8745

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205600806. Details of each certification follow.

• CCN 10C0001768 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 10C0001768

Legal name

FKP TAMPA AMBULATORY SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Mar 21, 2025

Last certification

Mar 13, 2025

Ownership / control type

Proprietary

Facility address

514 Eichenfeld Dr
Brandon, FL 33511

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emil S Abdulhayoglu, MD

  • Nephrology Physician
  • Riverview, FL
  • NPI 1801860671
  Medicare reassignment NPD

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1205600806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARKWAY NORTH BLVD STE 200S",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152534",
            "telephone_number": "847-388-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 EICHENFELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115955",
            "telephone_number": "813-358-1568",
            "fax_number": "813-200-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FKP TAMPA AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "ELLENBURG",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CHIEF OF PROVIDER GROUP OPERATIONS",
        "authorized_official_telephone_number": "480-421-8745"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Fishman, M.D.
• Jessica A Fitzgerald
• Marietta Windham Fitzgerald, LMHC
• Lauryn Marie Fitzpatrick
• Natasha Fix
• Heather Erin Flanagan, ARNP
• Cheneil Fleary-Walker, APRN
• Robert Fleege
• Anne Fleming
• Sharon Delois Fleming, RPH

• Ambulatory Surgical Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.