Provider Demographics
NPI:1881876951
Name:WOUGHTER SURGICAL ASSIST INC
Entity type:Organization
Organization Name:WOUGHTER SURGICAL ASSIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:WOUGHTER
Authorized Official - Suffix:
Authorized Official - Credentials:CST CFA
Authorized Official - Phone:813-451-9796
Mailing Address - Street 1:1910 DERBYWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510
Mailing Address - Country:US
Mailing Address - Phone:813-451-9796
Mailing Address - Fax:
Practice Address - Street 1:1910 DERBYWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510
Practice Address - Country:US
Practice Address - Phone:813-451-9796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Multi-Specialty