# PHYSICIAN ASSISTANT SERVICES OF FLORIDA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972673184
- **Authorized official:** CHARLES HAMILTON BOONE PA-C (OWNER)
- **Authorized official phone:** (321) 409-8941

## Contact information

- **Practice address:** 301 E HIBISCUS BLVD, MELBOURNE, FL 32901-3105
- **Practice address phone:** (321) 409-8941
- **Practice address fax:** (321) 409-9392
- **Mailing address:** PO BOX 1261, MELBOURNE, FL 32902-1261
- **Mailing address phone:** (321) 409-8941
- **Mailing address fax:** (321) 409-9392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | PA3525 | FL | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 04/20/2008