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General NPI Number Information
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NPI Number | 1093281693
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Entity Type | Organization
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Legal Business Name | SURGICAL HEALTH SOLUTIONS
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Dates
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Enumeration Date | 10/22/2018
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 5389 NW THYER CIR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-3329
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Country | US
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Telephone | 772-204-5412
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Fax |
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Provider Business Mailing Address
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Address Line | 5389 NW THYER CIR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-3329
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Country | US
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Telephone | 772-204-5412
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. DAVID MILTON LURRY IV
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Credential | CSFA
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Telephone | 772-204-5412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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Taxonomy #2
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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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