Provider Demographics
NPI:1720401516
Name:RLB SURGICAL ASSISTING LLC
Entity Type:Organization
Organization Name:RLB SURGICAL ASSISTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNARD
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:727-494-6863
Mailing Address - Street 1:7149 COLUMNS CIR
Mailing Address - Street 2:APT 102
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-3660
Mailing Address - Country:US
Mailing Address - Phone:727-494-6863
Mailing Address - Fax:727-807-9758
Practice Address - Street 1:7149 COLUMNS CIR
Practice Address - Street 2:APT 102
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-3660
Practice Address - Country:US
Practice Address - Phone:727-494-6863
Practice Address - Fax:727-807-9758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty