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Organization

MIAMI FIRST ASSIST, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY T GRAY PA-C (CFO & TREASURER)
(615) 345-5550
Entity
Organization

Contact information

Practice address
1600 SARNO ROAD, SUITE 15, MELBOURNE, FL 32935
(800) 348-4565
(321) 610-5115
Mailing address
214 CENTERVIEW DRIVE, SUITE 100, BRENTWOOD, TN 37027
(615) 345-5450
(615) 345-5365

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000151200
FL
01
AH964
MEDICARE GROUP PTAN
FL
Enumeration date
10/17/2006
Last updated
09/25/2014
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