Provider Demographics
NPI:1932478534
Name:NORTHSTAR SURGICAL ASSISTING, INC
Entity Type:Organization
Organization Name:NORTHSTAR SURGICAL ASSISTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-523-0623
Mailing Address - Street 1:1035 GATEWAY BLVD
Mailing Address - Street 2:SUITE 201-172
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8349
Mailing Address - Country:US
Mailing Address - Phone:561-523-0623
Mailing Address - Fax:561-336-3956
Practice Address - Street 1:1035 GATEWAY BLVD
Practice Address - Street 2:SUITE 201-172
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8349
Practice Address - Country:US
Practice Address - Phone:561-523-0623
Practice Address - Fax:561-336-3956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty