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General NPI Number Information
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NPI Number | 1760777007
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Entity Type | Organization
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Legal Business Name | SURGICAL STAFFING DEVELOPMENT AND SERVICES, INC.
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 7142 LAUREL LN
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2664
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Country | US
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Telephone | 786-252-2243
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Fax | 305-362-3989
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Provider Business Mailing Address
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Address Line | PO BOX 4722
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City | HIALEAH
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State | FL
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Zip | 33014-0722
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Country | US
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Telephone | 786-252-2243
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Fax | 305-362-3989
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Authorized Official
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Title or Position | DIRECTOR
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Name | ELIZABETH HERNANDEZ
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Credential |
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Telephone | 786-252-2243
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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 | PA 9101047
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License Number State | FL
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