Healthcare Provider Details

I. General information

NPI: 1104366616
Provider Name (Legal Business Name): ASSIST AT EASE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3467 W HILLSBORO BLVD STE A
DEERFIELD BEACH FL
33442-9473
US

IV. Provider business mailing address

PO BOX 4201
DEERFIELD BEACH FL
33442-4201
US

V. Phone/Fax

Practice location:
  • Phone: 954-274-5619
  • Fax: 754-227-5792
Mailing address:
  • Phone: 954-274-5619
  • Fax: 754-227-5792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: BRICKLIN WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 954-274-5619