Organization
MINIMALLY INVASIVE SURGICAL ASSIST, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKELINE PLACENCIA PA (PRESIDENT)
(954) 826-7215
Entity
Organization
Contact information
Practice address
936 NW 118TH LN, CORAL SPRINGS, FL 33071-5048
(954) 826-7215
Mailing address
936 NW 118TH LN, CORAL SPRINGS, FL 33071-5048
(954) 826-7215
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
PA9104564
FL
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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