Individual
EMMANUEL CIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
23237 SW 61ST AVE, BOCA RATON, FL 33428-2023
(561) 891-3316
Mailing address
23237 SW 61ST AVE, BOCA RATON, FL 33428-2023
(561) 891-3316
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
17-460
FL
363A00000X
Physician Assistant
Primary
000263-P.A
PR
Other
Enumeration date
09/28/2017
Last updated
07/21/2022
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