Provider Demographics
NPI:1780761858
Name:A AMERICAN SURGICAL SUPPLY CORP
Entity type:Organization
Organization Name:A AMERICAN SURGICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-983-4166
Mailing Address - Street 1:3600 S STATE ROAD 7
Mailing Address - Street 2:STE 319
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5200
Mailing Address - Country:US
Mailing Address - Phone:954-983-4166
Mailing Address - Fax:954-983-4166
Practice Address - Street 1:3600 S STATE ROAD 7
Practice Address - Street 2:STE 319
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5200
Practice Address - Country:US
Practice Address - Phone:954-983-4166
Practice Address - Fax:954-983-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL695332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0827530001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER