Organization
SUNCOAST HERNANDO SURGICAL ASSISTING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDITH A KOSTER PA-C (REGISTERED AGENT)
(352) 592-4696
Entity
Organization
Contact information
Practice address
5115 SUWANNEE RD, WEEKI WACHEE, FL 34607-2354
(352) 592-4696
Mailing address
5115 SUWANNEE RD, WEEKI WACHEE, FL 34607-2354
(352) 592-4696
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102477
FL
Other
Enumeration date
12/01/2012
Last updated
12/01/2012
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