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General NPI Number Information
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NPI Number | 1205399946
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Entity Type | Organization
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Legal Business Name | USA UNITED SURGICAL ASSISTANTS
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 04/10/2019
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Provider Practice Location Address
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Address Line | BAHRI SURGICAL CENTER 9726 TOUCHTON RD
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City | JACKSONVILLE
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State | FL
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Zip | 32246
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Country | US
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Telephone | 904-574-8680
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Fax |
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Provider Business Mailing Address
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Address Line | 745 PORTA ROSA CIR
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-0476
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Country | US
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Telephone | 727-514-1188
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Fax | 904-212-2744
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Authorized Official
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Title or Position | RN, SFA, CSA, SA-C
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Name | MR. LEONARD MICHAEL VOLPE
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Credential | RN, SFA, CSA, SA-C
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Telephone | 727-514-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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