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General NPI Number Information
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NPI Number | 1043469257
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Entity Type | Organization
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Legal Business Name | MOBILE SURGICAL SERVICES INC
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 10110 NW 49TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-1710
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Country | US
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Telephone | 561-319-6901
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Fax | 954-757-6019
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Provider Business Mailing Address
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Address Line | 10110 NW 49TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-1710
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Country | US
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Telephone | 561-319-6901
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Fax | 954-757-6019
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WASHINGTON CABEZAS
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Credential | PA
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Telephone | 561-319-6901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA2293
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License Number State | FL
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