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NPI Code Detail

MEDICARE: SCRUB IN SURGICAL ASSISTANTS LLC.

MEDICARE: SCRUB IN SURGICAL ASSISTANTS LLC.
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
1246ZC0007XSurgical Assistant
2363AS0400XSurgical Physician Assistant

General Provider Information

NPI Number : 1386269132
Entity Type Code : Organization
Provider Name (Legal Business Name) : SCRUB IN SURGICAL ASSISTANTS LLC.
Provider Business Mailing Address
First Line : 935 KOKOMO KEY LN
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33483-6031
Country : US
Telephone Number : 312-315-8840
Fax Number :
Provider Business Practice Location Address
First Line : 935 KOKOMO KEY LN
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33483-6031
Country : US
Telephone Number : 312-315-8840
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOHN FRANCISCO MARTINEZ JIMENEZ
Credential : SA-C
Telephone Number : 312-315-8840
Provider Enumeration Date : 06/08/2020
Last Update Date : 12/03/2021

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Directions to “SCRUB IN SURGICAL ASSISTANTS LLC. ” Practice Location

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