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General NPI Number Information
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NPI Number | 1134250509
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Entity Type | Organization
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Legal Business Name | SURGICAL SPECIALIST OF TREASURE COAST PA
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 2215 NEBRASKA AVE SUITE 1A
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City | FORT PIERCE
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State | FL
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Zip | 34950
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Country | US
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Telephone | 772-464-8722
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Fax | 772-464-9978
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Provider Business Mailing Address
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Address Line | 2215 NEBRASKA AVE SUITE 1A
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City | FORT PIERCE
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State | FL
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Zip | 34950
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Country | US
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Telephone | 772-464-8722
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Fax | 772-464-9978
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Authorized Official
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Title or Position | PRESIDENT OF SURGICAL SPECIALISTS
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Name | DR. ROSHAN L H SINGH
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Credential | MD FACS
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Telephone | 772-464-8722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME35626
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License Number State |
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