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General NPI Number Information
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NPI Number | 1245896778
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ASSOCIATES OF SURGICAL SERVICES INC.
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 3136 BIGHORN CT
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City | PUEBLO
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State | CO
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Zip | 81005-4016
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Country | US
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Telephone | 719-320-0329
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Fax | 719-566-1980
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Provider Business Mailing Address
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Address Line | 3136 BIGHORN CT
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City | PUEBLO
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State | CO
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Zip | 81005-4016
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Country | US
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Telephone | 719-320-0329
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Fax | 719-566-1980
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Authorized Official
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Title or Position | SURGICAL ASSISTANT
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Name | DANIEL J. FLORES
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Credential |
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Telephone | 719-320-0329
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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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