Healthcare Provider Details
I. General information
NPI: 1023418175
Provider Name (Legal Business Name): ASSOCIATED FIRST ASSISTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2014
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4233 W. HILLSBORO BLVD
COCONUT CREEK FL
33097-0528
US
IV. Provider business mailing address
4233 W. HILLSBORO BLVD
COCONUT CREEK FL
33097-0528
US
V. Phone/Fax
- Phone: 954-227-8224
- Fax: 954-227-7442
- Phone: 954-227-8224
- Fax: 954-227-7442
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | RN1213182 |
| License Number State | FL |
VIII. Authorized Official
Name: MRS.
DEBORAH
BANKER
Title or Position: PRESIDENT
Credential:
Phone: 954-227-8224