Organization
KEYES SURGICAL ASSIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MILLER KEYES PA-C (PHYSICIAN ASSISTANT CERTIFIED)
(772) 398-9763
Entity
Organization
Contact information
Practice address
1700 S 23RD ST, FORT PIERCE, FL 34950-4803
(772) 461-4000
(772) 467-2856
Mailing address
132 WIDE RIVER CV, STUART, FL 34994-9132
(772) 398-9763
(772) 337-7548
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2081
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65113
METCARE
—
01
—
DF1932
MEDICARE RAILROAD
FL
01
—
X1622
BCBS
FL
Enumeration date
01/19/2007
Last updated
11/20/2007
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