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General NPI Number Information
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NPI Number | 1093389819
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSIST SOLUTIONS LLC
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 325 TURTLE CV
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32413-8441
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Country | US
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Telephone | 901-486-9414
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Fax |
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Provider Business Mailing Address
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Address Line | 19211 PANAMA CITY BEACH PKWY #1030
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32413-8712
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Country | US
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Telephone | 901-486-9414
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAMI L HATLEY
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Credential | CSFA, CST
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Telephone | 901-486-9414
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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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