Organization
ADVANCED SURGICAL & PHYSICIAN ASSISTANT SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE P GREYSLAK PAC (OWNER)
(407) 451-0192
Entity
Organization
Contact information
Practice address
461 MALLARD LN, INDIALANTIC, FL 32903-4735
(407) 451-0192
(321) 600-4004
Mailing address
PO BOX 410185, MELBOURNE, FL 32941-0185
(407) 451-0192
(321) 600-4004
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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