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General NPI Number Information
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NPI Number | 1699338418
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Entity Type | Organization
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Legal Business Name | PA PLUS SURGICAL SERVICES,PLLC
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 815 NE 27TH AVE
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-2945
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Country | US
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Telephone | 954-699-5161
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Fax |
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Provider Business Mailing Address
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Address Line | 815 NE 27TH AVE
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-2945
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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 | MANAGER
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Name | MRS. YANA DODEA
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Credential | PA
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Telephone | 954-699-5161
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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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