Provider Demographics
NPI:1295453074
Name:SURGIASSIST, INC
Entity type:Organization
Organization Name:SURGIASSIST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:ROBERTI GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-252-2679
Mailing Address - Street 1:21341 WINDY HILL DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8621
Mailing Address - Country:US
Mailing Address - Phone:786-252-2679
Mailing Address - Fax:815-806-7044
Practice Address - Street 1:21341 WINDY HILL DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-8621
Practice Address - Country:US
Practice Address - Phone:786-252-2679
Practice Address - Fax:815-806-7044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty