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General NPI Number Information
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NPI Number | 1073261814
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSISTING OF BROWARD
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 8041 NW 71ST CT
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City | TAMARAC
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State | FL
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Zip | 33321-2761
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Country | US
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Telephone | 954-684-3410
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15193
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City | PLANTATION
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State | FL
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Zip | 33318-5193
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Country | US
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Telephone | 954-684-3410
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Fax |
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Authorized Official
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Title or Position | SURGICAL ASSISTANT
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Name | EILEEN CRIGLER
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Credential | SURGICIAL ASSISTANT
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Telephone | 954-684-3410
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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 |
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License Number State |
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