Provider Demographics
NPI:1093281693
Name:SURGICAL HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:SURGICAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:LURRY
Authorized Official - Suffix:IV
Authorized Official - Credentials:CSFA
Authorized Official - Phone:772-204-5412
Mailing Address - Street 1:5389 NW THYER CIR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-3329
Mailing Address - Country:US
Mailing Address - Phone:772-204-5412
Mailing Address - Fax:
Practice Address - Street 1:5389 NW THYER CIR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-3329
Practice Address - Country:US
Practice Address - Phone:772-204-5412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty