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General NPI Number Information
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NPI Number | 1073404877
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Entity Type | Organization
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Legal Business Name | PRS SURGICAL, LLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 2745 NW 62ND ST
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-1721
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Country | US
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Telephone | 586-260-4665
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Fax |
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Provider Business Mailing Address
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Address Line | 2745 NW 62ND ST
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-1721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | SAMANTHA LARSON
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Credential | RN
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Telephone | 586-260-4665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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