Surgery Center of Tboplastics, LLC

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

Legal business name

SURGERY CENTER OF TBOPLASTICS, LLC

Practice address

2963 Gulf to Bay Blvd Ste 267
Clearwater, FL 33759-4255

Phone

(727) 285-8006

Fax

(727) 216-6560

NPI assigned

Dec 18, 2023

Last updated

Jan 11, 2024By 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

Kendra Deangelis, MDNPI 1043506595

Title

Owner

Phone

(727) 285-8006

Specialties & licenses 1

Addresses

Other names 1

• Surgery Center of TBOPlastics Former legal business name

Locations

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.

• Kendra Denise Deangelis, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Clearwater, FL
  • NPI 1043506595
  NPD Authorized official

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1841068095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 WESTLEY ST",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346952709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 GULF TO BAY BLVD STE 267",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594255",
            "telephone_number": "727-285-8006",
            "fax_number": "727-216-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF TBOPLASTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "DEANGELIS",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-285-8006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery Center of TBOPlastics",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Surgery Center of TBOPlastics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Ophthalmic Plastic and Reconstructive Surgery Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.