Organization
WEST PALM BEACH SURGICAL ASSISTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SANTORO (SA-C)
(561) 631-8171
Entity
Organization
Contact information
Practice address
10628 PASO FINO DR, LAKE WORTH, FL 33449-8018
(561) 631-8171
(561) 631-8171
Mailing address
PO BOX 210241, ROYAL PALM BEACH, FL 33421-0241
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-195
ABSA CERT - SURGICAL ASSISTANT - CERTIFIED
FL
Enumeration date
03/18/2020
Last updated
05/17/2020
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