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General NPI Number Information
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NPI Number | 1679921431
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Entity Type | Organization
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Legal Business Name | DAMATO SURGICAL ASSISTING, LLC
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 1350 13TH ST
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City | ORANGE CITY
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State | FL
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Zip | 32763-3214
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Country | US
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Telephone | 386-774-7985
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 13TH ST
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City | ORANGE CITY
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State | FL
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Zip | 32763-3214
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Country | US
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Telephone | 386-774-7985
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Fax |
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Authorized Official
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Title or Position | SURGICAL FIRST ASSIST
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Name | MRS. CAROLYN ANN DAMATO
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Credential | CSTFA
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Telephone | 386-774-7985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State | FL
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