Organization
PLATINUM SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFAEL J NOLLIE CSA/LPN (PRESIDENT)
(301) 363-4934
Entity
Organization
Contact information
Practice address
8115 MAPLE LAWN BLVD STE 350, FULTON, MD 20759-2683
(301) 363-4934
Mailing address
3570 OLNEY LAYTONSVILLE RD UNIT 71, OLNEY, MD 20830-7503
(301) 363-4934
(301) 363-4934
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LP49426
MD
246ZS0410X
Surgical Technologist
Primary
3077
MD
Other
Enumeration date
01/12/2014
Last updated
06/13/2023
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