Provider Demographics
NPI:1023787488
Name:SURGCENTER OF RIVERVIEW, LLC
Entity type:Organization
Organization Name:SURGCENTER OF RIVERVIEW, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATTERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-415-2137
Mailing Address - Street 1:1715 N WEST SHORE BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-3911
Mailing Address - Country:US
Mailing Address - Phone:813-870-1000
Mailing Address - Fax:813-870-1025
Practice Address - Street 1:1715 N WEST SHORE BLVD STE 190
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-3911
Practice Address - Country:US
Practice Address - Phone:813-870-1000
Practice Address - Fax:813-870-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical