Provider Demographics
NPI:1194761288
Name:SURGICAL ASSISTING SERVICES, INC.
Entity type:Organization
Organization Name:SURGICAL ASSISTING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:A
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:772-216-6174
Mailing Address - Street 1:PO BOX 871
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34954-0871
Mailing Address - Country:US
Mailing Address - Phone:772-216-6174
Mailing Address - Fax:772-398-2604
Practice Address - Street 1:1532 SE ROYAL GREEN CIR APT O101
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7693
Practice Address - Country:US
Practice Address - Phone:772-216-6174
Practice Address - Fax:772-398-2604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2905363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDB1964OtherRAILROAD
FLX1586OtherBLUE CROSS
FLK5229Medicare PIN