MEDICARE: SURGICAL ASSISTANT SERVICES INC.

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	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1225164395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL ASSISTANT SERVICES INC.

Provider Business Mailing Address
First Line	:	PO BOX 450381
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33345-0381
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 SE 6TH ST
Second Line	:	SUITE #7
City	:	FT. LAUDERDALE
State	:	FL
Zip	:	33301-3429
Country	:	US
Telephone Number	:	877-563-3374
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM THOMAS BRESNIHAN JR.
Credential	:
Telephone Number	:	561-379-4994

Provider Enumeration Date	:	02/25/2007
Last Update Date	:	05/08/2017

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