Provider Demographics
NPI:1801028675
Name:KAD SURGICAL ASSISTING INC
Entity Type:Organization
Organization Name:KAD SURGICAL ASSISTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:CFA
Authorized Official - Phone:561-251-1309
Mailing Address - Street 1:1211 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1204
Mailing Address - Country:US
Mailing Address - Phone:561-251-1309
Mailing Address - Fax:561-395-2435
Practice Address - Street 1:1211 NW 15TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1204
Practice Address - Country:US
Practice Address - Phone:561-251-1309
Practice Address - Fax:561-395-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL163211183008OtherHUMANA