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General NPI Number Information
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NPI Number | 1861627952
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Entity Type | Organization
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Legal Business Name | JB SURGICAL ASSISTANCE INC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 8950 ALEXANDRA CIR
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City | WELLINGTON
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State | FL
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Zip | 33414-6438
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Country | US
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Telephone | 561-231-9372
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Fax | 866-277-6962
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Provider Business Mailing Address
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Address Line | 8950 ALEXANDRA CIR
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City | WELLINGTON
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State | FL
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Zip | 33414-6438
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Country | US
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Telephone | 561-231-9372
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Fax | 866-277-6962
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Authorized Official
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Title or Position | CEO
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Name | MR. JEAN C BONNET
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Credential | PA
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Telephone | 561-213-9372
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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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