Provider Demographics
NPI:1588983787
Name:FIRST ASSISTANT SERVICES, LLC
Entity type:Organization
Organization Name:FIRST ASSISTANT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:G
Authorized Official - Last Name:VIA Y RADA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:954-237-7728
Mailing Address - Street 1:19538 S WHITEWATER AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-2444
Mailing Address - Country:US
Mailing Address - Phone:954-237-7728
Mailing Address - Fax:866-240-3482
Practice Address - Street 1:19538 S WHITEWATER AVE
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33332-2444
Practice Address - Country:US
Practice Address - Phone:954-237-7728
Practice Address - Fax:866-240-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101346363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty