Organization
BAY AREA SURGICAL ASSISTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONARD PAUL JOHNS PA (PRESIDENT)
(813) 310-5679
Entity
Organization
Contact information
Practice address
4122 MADISON ST UNIT 262, ELFERS, FL 34680-9711
(813) 310-5679
Mailing address
4122 MADISON ST UNIT 262, ELFERS, FL 34680-9711
(813) 310-5679
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9102691
MEDICAL LICENSE
FL
Enumeration date
08/10/2017
Last updated
12/16/2024
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