Provider Demographics
NPI:1417036450
Name:HOPKINS SURGICAL ASSISTANCE, INC.
Entity Type:Organization
Organization Name:HOPKINS SURGICAL ASSISTANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/SEC
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CO-OWNER
Authorized Official - Phone:727-781-8685
Mailing Address - Street 1:36181 E LAKE RD # 390
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3142
Mailing Address - Country:US
Mailing Address - Phone:727-781-8685
Mailing Address - Fax:727-786-2852
Practice Address - Street 1:36181 E LAKE RD # 390
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-3142
Practice Address - Country:US
Practice Address - Phone:727-781-8685
Practice Address - Fax:727-786-2852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2314 & PA2614363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDC7366OtherRAILROAD GROUP #
FLX1569OtherBCBS GROUP #
FL291686000Medicaid
FLK4892AMedicare PIN
FLK4892Medicare PIN