Provider Demographics
NPI:1821277153
Name:SURGERY ASSISTANTS OF ORLANDO INC
Entity Type:Organization
Organization Name:SURGERY ASSISTANTS OF ORLANDO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROCHE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:SFA
Authorized Official - Phone:407-810-7968
Mailing Address - Street 1:PO BOX 691418
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-1418
Mailing Address - Country:US
Mailing Address - Phone:407-810-7968
Mailing Address - Fax:407-240-7681
Practice Address - Street 1:2105 MEADOWMOUSE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7414
Practice Address - Country:US
Practice Address - Phone:407-810-7968
Practice Address - Fax:407-240-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FM246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty