PREMIER SURGICAL ASSISTING LLC (NPI# 1972958767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972958767 |
Entity Type | Organization |
Organization Name | PREMIER SURGICAL ASSISTING LLC |
Practice Address |
10297 Sw West Park Ave Port St Lucie FL 34987-2118 |
Practice Telephone | 5612511309 |
Practice Fax Number | 7723456120 |
Mailing Telephone | 5612511309 |
Mailing Fax Number | 7723456120 |
Enumeration Date | 2016-04-28 |
Last Update Date | 2016-04-28 |
Authorized Official Name | KATHLEEN A DUFFY (MEMBER) |
Authorized Official Telephone | 5612511309 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
10297 SW WEST PARK AVE |
City | PORT ST LUCIE |
State | FL |
Zip Code | 34987-2118 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093299604 | Karen Cecilia Wong Li James | Registered Nurse | 10024 Sw Glenbrook Drive, Port Saint Lucie, FL 34987 | 2018-09-19 |
1134646151 | B & T Diagnostics LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 323, Port Saint Lucie, FL 34987 | 2017-08-30 |
1538684048 | Transport With Care, LLC | Non-emergency Medical Transport (VAN) | 1850 Sw Our Ct, Port Saint Lucie, FL 34987 | 2017-08-04 |
1154859825 | True Path Diagnostics, LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 309, Port St Lucie, FL 34987 | 2017-05-25 |
1316326515 | Aleksey Alekseyenko | Family Medicine | Mhpg Primary Care @ Tradition Health Park II, 10080 Sw Innovation Way Suite 201, Port St Lucie, FL 34987 | 2015-05-21 |
1053658583 | Tameka Argo | Contractor | 7664 Germany Canal Road, Fort Pierce, FL 34987 | 2013-01-03 |
1780967976 | Mennette J Colon | Specialist/Technologist, Other | 1970 Sw Glendale St., Port Saint Lucie, FL 34987 | 2011-09-23 |
1366416257 | Cynthia A Dolan | Dermatology | 10080 Sw Innovation Way Ste 301, Port St Lucie, FL 34987 | 2006-02-15 |
1205829074 | Andres M Reyes | Internal Medicine | 10050 Nw Innovation Way, Suite 102, Port St Lucie, FL 34987 | 2005-08-26 |
1720498470 | Josue Limage | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987 | 2014-05-03 |
Find all providers in zip 34987 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487162905 | Adley Dasilva | Physician Assistant | 1941 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5535 | 2018-01-18 |
1033565650 | Jennifer J Ramos | Physician Assistant | 1581 Sw Bayshore Blvd, Port St Lucie, FL 34983 | 2016-05-12 |
1396294419 | Stat Surgical First Assisting | Physician Assistant | 1581 Sw Bayshore Blvd, Port St Lucie, FL 34983 | 2016-09-30 |
1245248426 | Kelli Lugo | Physician Assistant | 9077 S Federal Hwy, Port St Lucie, FL 34952-3405 | 2006-08-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811598691 | Monica Nancy Ginocchio | Physician Assistant | 1020 Crosspointe Dr Ste 110, Naples, FL 34110-0918 | 2020-11-06 |
1427657055 | Alyson Ryall | Physician Assistant | 480 Ventura Pl, Vero Beach, FL 32963-4262 | 2020-10-24 |
1104436476 | Forrest Joseph Steslow | Physician Assistant | 1971 Brandywine Rd Apt 305, West Palm Beach, FL 33409-6800 | 2020-08-03 |
1063039576 | Joshua Bras Prewitt | Physician Assistant | 4800 Linton Blvd Ste 201, Delray Beach, FL 33445-6584 | 2020-06-30 |
1003443904 | Sheila Rhinehart | Physician Assistant | 981 Tarpon Ave, Sebastian, FL 32958-5147 | 2020-03-23 |
1952932493 | Lisel Spieler | Physician Assistant | 1173 Fins Up Ct, Daytona Beach, FL 32124-3719 | 2020-02-03 |
1326685991 | Nikolai X Lincavage | Physician Assistant | 29277 Us Highway 19 N # 29277, Clearwater, FL 33761-2102 | 2019-12-03 |
1356984686 | Zane K Jude | Physician Assistant | 1775 Linton Lake Dr, Delray Beach, FL 33445-6927 | 2019-10-18 |
1720635998 | Jose R Munoz | Physician Assistant | 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 | 2019-08-22 |
1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
Find all providers with the same taxonomy |
City | PORT ST LUCIE |
Zip Code | 34987 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.