Organization
DE LA SELVA FIRST ASSIST,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA DE LA SELVA MCMILLIAN CSFA (CSFA)
(210) 685-7023
Entity
Organization
Contact information
Practice address
4611 N FEDERAL HWY APT 221, POMPANO BEACH, FL 33064-6669
(210) 685-7023
Mailing address
4611 N FEDERAL HWY APT 221, POMPANO BEACH, FL 33064-6669
(210) 685-7023
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-254-044-66-926-0
FLORIDA DRIVERS LICENSE
FL
Enumeration date
03/15/2022
Last updated
03/15/2022
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