MEDICARE: NP SURGICAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1184242190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NP SURGICAL CORP

Provider Business Mailing Address
First Line	:	415 NW 109TH AVE
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-4056
Country	:	US
Telephone Number	:	954-398-0347
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 NW 109TH AVE
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-4056
Country	:	US
Telephone Number	:	954-398-0347
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	INDHIRA Y PENA
Credential	:	SA-C
Telephone Number	:	954-398-0347

Provider Enumeration Date	:	07/07/2020
Last Update Date	:	12/12/2023

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Directions to “NP SURGICAL CORP ” Practice Location

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