Organization Name: | SUNCOAST HERNANDO SURGICAL ASSISTING INC |
NPI Number: | 1023353125 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUDITH A KOSTER (REGISTERED AGENT) |
Mailing Address: | 5115 Suwannee Rd Weeki Wachee |
State: | FL US |
Postal Code: | 346072354 |
Phone Number: | 3525924696 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2012 |
NPI Last Update Date: | 12/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | PA9102477 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |