Provider Demographics
NPI:1386338820
Name:PAMELA'S ASSIDUOUS MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:PAMELA'S ASSIDUOUS MEDICAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:863-904-9683
Mailing Address - Street 1:831 ENTERPRISE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-6522
Mailing Address - Country:US
Mailing Address - Phone:386-232-8829
Mailing Address - Fax:
Practice Address - Street 1:831 ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-6522
Practice Address - Country:US
Practice Address - Phone:386-232-8829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty