Provider Demographics
NPI:1679921431
Name:DAMATO SURGICAL ASSISTING, LLC
Entity Type:Organization
Organization Name:DAMATO SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL FIRST ASSIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DAMATO
Authorized Official - Suffix:
Authorized Official - Credentials:CSTFA
Authorized Official - Phone:386-774-7985
Mailing Address - Street 1:1350 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-3214
Mailing Address - Country:US
Mailing Address - Phone:386-774-7985
Mailing Address - Fax:
Practice Address - Street 1:1350 13TH ST
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-3214
Practice Address - Country:US
Practice Address - Phone:386-774-7985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty