Organization
SOUTHLAKE SURGICAL ASSISTANT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ANGELO GRANADOS (OWNER)
(954) 599-7778
Entity
Organization
Contact information
Practice address
20 VIA DE CASAS SUR APT 204, BOYNTON BEACH, FL 33426-8850
(954) 599-7778
Mailing address
20 VIA DE CASAS SUR APT 204, BOYNTON BEACH, FL 33426-8850
(954) 599-7778
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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