Provider Demographics
NPI:1417265422
Name:ADVANCED SURGICAL PARTNERS, PC
Entity Type:Organization
Organization Name:ADVANCED SURGICAL PARTNERS, PC
Other - Org Name:ADVANCED SURGICAL PARTNERS ASC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:340-715-7779
Mailing Address - Street 1:9086 PETERS REST
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-5617
Mailing Address - Country:US
Mailing Address - Phone:340-715-7779
Mailing Address - Fax:877-451-0206
Practice Address - Street 1:4500 SUNNY ISLE STE 26B
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4493
Practice Address - Country:US
Practice Address - Phone:340-715-7779
Practice Address - Fax:877-451-0206
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED SURGICAL PARTNERS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-24
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1613208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty