Provider Demographics
NPI:1043676794
Name:SURGIASSIST
Entity Type:Organization
Organization Name:SURGIASSIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-303-1124
Mailing Address - Street 1:2101 VISTA PKWY
Mailing Address - Street 2:STE 4029
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2706
Mailing Address - Country:US
Mailing Address - Phone:866-931-4777
Mailing Address - Fax:
Practice Address - Street 1:1309 N FLAGLER DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3406
Practice Address - Country:US
Practice Address - Phone:866-931-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9164311163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty