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General NPI Number Information
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NPI Number | 1942786702
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Entity Type | Organization
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Legal Business Name | FLORIDA SURGICAL FIRST ASSISTING LLC
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 03/20/2019
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Provider Practice Location Address
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Address Line | 52 TUSCAN WAY STE 202-213
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-1850
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Country | US
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Telephone | 310-294-0131
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Fax |
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Provider Business Mailing Address
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Address Line | 52 TUSCAN WAY STE 202-213
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-1850
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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 | CSFA
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Name | MISS ANGELA SANCHEZ
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Credential | CSFA
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Telephone | 310-294-0131
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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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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 |
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