Surgical Practice Resource Group of Florida Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SURGICAL PRACTICE RESOURCE GROUP OF FLORIDA INC

Practice address

539 Rolling Acres Rd
Lady Lake, FL 32159

Phone

(352) 775-6348

NPI assigned

Jan 19, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Steve Roth

Title

Coo

Phone

(352) 775-6348

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Unova ASC, LLC

  • Ambulatory Surgical Clinic/Center
  • Lady Lake, FL
  • NPI 1750169975

  Member Of

  NPD member

Locations

Practitioners 6

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

• Jeffrey Mandume Kerina, M.D.

  • Orthopaedic Surgery Physician
  • Leesburg, FL
  • NPI 1447369376
  Medicare reassignment Care Compare group NPD
• Matthew Meyer, MSN

  • Emergency Registered Nurse
  • Leesburg, FL
  • NPI 1396267753
  Medicare reassignment Care Compare group NPD
• Thomas Hatton McCoy, MD

  • Orthopaedic Surgery Physician
  • Lady Lake, FL
  • NPI 1255313730
  Medicare reassignment NPD
• Claudia L Thomas, M.D.

  • Orthopaedic Surgery Physician
  • Leesburg, FL
  • NPI 1538194345
  Medicare reassignment NPD
• Myriam Vicioso

  • Physical Therapist
  • Bushnell, FL
  • NPI 1124240007
  Medicare reassignment NPD
• Nadine Latoya Williams, MD

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
  • NPI 1992971840

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1992162291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321580489",
            "telephone_number": "352-775-6348",
            "fax_number": "352-775-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 ROLLING ACRES RD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-775-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL PRACTICE RESOURCE GROUP OF FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "352-775-6348",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristyn Rene Talaber, COTA/L
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• Rachel Beverly Tallbacka, P.A..
• Roberto A Tellez, PHARM D.

• Multi-Specialty Clinic/Center in Lady Lake, FL
• Providers in Lady Lake, 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 Aug 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.