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Organization
PROFESSIONAL SURGICAL ASSISTANTS
Active
Organization
PROFESSIONAL SURGICAL ASSISTANTS
Active
Other names
Christina H Repka RSA
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA H REPKA RSA (OWNER)
(708) 269-0669
Entity
Organization
Contact information
Practice address
120 ACKLINS CIR APT 112, DAYTONA BEACH, FL 32119-9762
(708) 269-0669
(800) 821-4719
Mailing address
PO BOX 291613, PORT ORANGE, FL 32129-1613
(386) 562-7052
(800) 821-4719
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/24/2019
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