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General NPI Number Information
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NPI Number | 1194761288
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSISTING SERVICES, INC.
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 1532 SE ROYAL GREEN CIR APT O101
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-7693
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Country | US
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Telephone | 772-216-6174
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Fax | 772-398-2604
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Provider Business Mailing Address
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Address Line | PO BOX 871
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City | FORT PIERCE
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State | FL
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Zip | 34954-0871
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Country | US
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Telephone | 772-216-6174
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Fax | 772-398-2604
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. VERNON A WRIGHT
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Credential | PA
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Telephone | 772-216-6174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2905
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License Number State | FL
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