Provider Demographics
NPI:1609036110
Name:INTRALIGN FL LLC
Entity Type:Organization
Organization Name:INTRALIGN FL LLC
Other - Org Name:UNITED SURGICAL ASSISTANTS INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR, CENTRAL BILLING OPERATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-343-5500
Mailing Address - Street 1:PO BOX 21686
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-1686
Mailing Address - Country:US
Mailing Address - Phone:813-343-5500
Mailing Address - Fax:813-343-5506
Practice Address - Street 1:12880 COMMODITY PLACE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-3101
Practice Address - Country:US
Practice Address - Phone:813-343-5500
Practice Address - Fax:813-343-5506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1758AMedicare PIN