Healthcare Provider Details

I. General information

NPI: 1912078916
Provider Name (Legal Business Name): FLORIDA SURGICAL ASSISTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11750 SW 40 ST
MIAMI FL
33175
US

IV. Provider business mailing address

PO BOX 650990
MIAMI FL
33265
US

V. Phone/Fax

Practice location:
  • Phone: 305-227-5557
  • Fax: 305-228-5435
Mailing address:
  • Phone: 305-223-3000
  • Fax: 305-228-5435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JULIO VALDES
Title or Position: PRESIDENT
Credential: SAC
Phone: 305-223-3000