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General NPI Number Information
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NPI Number | 1467229450
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Entity Type | Organization
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Legal Business Name | AG SURGICAL ASSIST GROUP LLC
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Dates
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Enumeration Date | 12/08/2023
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 4871 NW 22ND ST
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City | COCONUT CREEK
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State | FL
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Zip | 33063-3868
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Country | US
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Telephone | 818-237-6588
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Fax |
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Provider Business Mailing Address
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Address Line | 4871 NW 22ND ST
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City | COCONUT CREEK
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State | FL
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Zip | 33063-3868
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA GALETTE
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Credential |
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Telephone | 818-237-6588
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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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