Organization
OCEANSIDE ELITE SURGICAL ASSISTING, LLC
Active
Organization
OCEANSIDE ELITE SURGICAL ASSISTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELBY ALLISON LANE PA-C (PRESIDENT)
(954) 257-7859
Entity
Organization
Contact information
Practice address
3319 NE 15TH CT, FORT LAUDERDALE, FL 33304-1709
(954) 257-7859
(954) 616-8063
Mailing address
3319 NE 15TH CT, FORT LAUDERDALE, FL 33304-1709
(954) 257-7859
(954) 616-8063
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/21/2019
Last updated
09/16/2019
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