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General NPI Number Information
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NPI Number | 1699864579
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL SURGICAL ASSISTANTS, INC.
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 06/05/2009
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Provider Practice Location Address
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Address Line | 7770 HAWTHORNE AVE
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City | MIAMI BEACH
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State | FL
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Zip | 33141-1038
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Country | US
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Telephone | 305-968-1829
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Fax | 305-866-2486
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Provider Business Mailing Address
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Address Line | 7770 HAWTHORNE AVE
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City | MIAMI BEACH
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State | FL
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Zip | 33141-1038
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Country | US
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Telephone | 305-968-1829
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Fax | 305-866-2486
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MIGUEL P LETOURNEAUT
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Credential | P.A.
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Telephone | 305-968-1829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | FL
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Taxonomy #2
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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 | FL
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