Organization
MIAMI FIRST ASSIST, LLC
Active
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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