Park Place Surgery Center L L C

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

1208 Issued in FL

Legal business name

PARK PLACE SURGERY CENTER L L C

Practice address

2450 Maitland Center Pkwy
Suite 100
Maitland, FL 32751-4140

Phone

(407) 875-0296

Fax

(407) 875-0929

NPI assigned

Jul 21, 2006

Last updated

Jan 30, 2008By 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

Mr. Michael Doyle

Title

President/Coo

Phone

(813) 569-6500

Specialties & licenses 1

Addresses

Other names 1

• Park Place Surgery Center Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Park PL Surgery Center LLCCCN 10C0001430

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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.

• Thomas R Fann, DPM

  • Podiatrist
  • Casselberry, FL
  • NPI 1396852364
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1306866173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 MAITLAND CENTER PKWY",
            "address_2": "SUITE 100",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514140",
            "telephone_number": "407-875-0296",
            "fax_number": "407-875-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 MAITLAND CENTER PKWY",
            "address_2": "SUITE 100",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514140",
            "telephone_number": "407-875-0296",
            "fax_number": "407-875-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE SURGERY CENTER L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "813-569-6500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "1208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Place Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cheryl Kathleen Parham, P.T.
• Amish M Parikh, M.D.
• Tara Paris
• Brooke Alexandria Parisian, AA
• Park North Dermatology, PA
• Teresa Faye Parnell, PSY.D.
• Paul N Passafiume, MD
• Heidi Louise Pastor, CRNA
• Asmita Patel, DO
• Neel R Patel, M.D.

• Multi-Specialty Clinic/Center in Maitland, FL
• Providers in Maitland, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.