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General NPI Number Information
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NPI Number | 1821277153
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Entity Type | Organization
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Legal Business Name | SURGERY ASSISTANTS OF ORLANDO INC
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 2105 MEADOWMOUSE ST
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City | ORLANDO
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State | FL
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Zip | 32837-7414
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Country | US
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Telephone | 407-810-7968
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Fax | 407-240-7681
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Provider Business Mailing Address
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Address Line | PO BOX 691418
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City | ORLANDO
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State | FL
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Zip | 32869-1418
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Country | US
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Telephone | 407-810-7968
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Fax | 407-240-7681
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROCHE CAMPBELL
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Credential | SFA
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Telephone | 407-810-7968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number |
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License Number State | FM
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