Provider Demographics
NPI:1427080472
Name:CERTIFIED SURGICAL ASSISTANTS PA,INC.
Entity type:Organization
Organization Name:CERTIFIED SURGICAL ASSISTANTS PA,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SURGEON
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:813-417-0043
Mailing Address - Street 1:2801 HARDER OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-4238
Mailing Address - Country:US
Mailing Address - Phone:813-417-0043
Mailing Address - Fax:813-662-9325
Practice Address - Street 1:119 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5779
Practice Address - Country:US
Practice Address - Phone:813-661-5551
Practice Address - Fax:813-657-0691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1751202282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital