Provider Demographics
NPI:1285995837
Name:AMELIA SURGICAL ASSISTANTS LLC
Entity type:Organization
Organization Name:AMELIA SURGICAL ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:TOVAR
Authorized Official - Last Name:EURESTE
Authorized Official - Suffix:
Authorized Official - Credentials:C-SA
Authorized Official - Phone:301-424-1960
Mailing Address - Street 1:9715 MEDICAL CENTER DR STE 528
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3352
Mailing Address - Country:US
Mailing Address - Phone:301-424-1960
Mailing Address - Fax:301-424-1961
Practice Address - Street 1:9715 MEDICAL CENTER DR STE 528
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3352
Practice Address - Country:US
Practice Address - Phone:301-424-1960
Practice Address - Fax:301-424-1961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty