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General NPI Number Information
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NPI Number | 1689532483
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Entity Type | Organization
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Legal Business Name | FIRST COAST SURGICAL ASSISTANTS
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 3500 WHISPER CREEK BLVD
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City | MIDDLEBURG
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State | FL
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Zip | 32068-3482
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Country | US
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Telephone | 229-569-5096
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 WHISPER CREEK BLVD
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City | MIDDLEBURG
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State | FL
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Zip | 32068-3482
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Country | US
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Telephone | 229-569-5096
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL WAYMON HORNE
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Credential | CSFA
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Telephone | 229-569-5096
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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 |
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