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General NPI Number Information
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NPI Number | 1912721093
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Entity Type | Organization
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Legal Business Name | ADVENTHEALTH RIVERVIEW
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 9330 US 301 S
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City | RIVERVIEW
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State | FL
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Zip | 33578-6300
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Country | US
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Telephone | 860-480-2994
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Fax |
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Provider Business Mailing Address
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Address Line | 9330 US 301 S
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City | RIVERVIEW
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State | FL
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Zip | 33578-6300
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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 | SURGICAL FIRST ASSIST
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Name | ALLEN SMITH
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Credential |
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Telephone | 813-334-7660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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