Provider Demographics
NPI:1073261814
Name:SURGICAL ASSISTING OF BROWARD
Entity Type:Organization
Organization Name:SURGICAL ASSISTING OF BROWARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:SURGICIAL ASSISTANT
Authorized Official - Phone:954-720-8386
Mailing Address - Street 1:PO BOX 15193
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318-5193
Mailing Address - Country:US
Mailing Address - Phone:954-720-8386
Mailing Address - Fax:
Practice Address - Street 1:8041 NW 71ST CT
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2761
Practice Address - Country:US
Practice Address - Phone:954-720-8386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty