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General NPI Number Information
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NPI Number | 1982023321
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Entity Type | Organization
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Legal Business Name | HOUSER SURGICAL
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 1040 WANDERING WILLOW WAY
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-6081
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Country | US
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Telephone | 561-635-5105
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1518
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-1518
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Country | US
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Telephone | 561-635-5105
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAROD L HOUSER SR.
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Credential | CSFA
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Telephone | 561-635-5105
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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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