1235411091 NPI number — GUARDIAN SURGICAL ASSISTANTS, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235411091 NPI number — GUARDIAN SURGICAL ASSISTANTS, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GUARDIAN SURGICAL ASSISTANTS, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235411091
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
206 S. HAYS ST.
Provider Second Line Business Mailing Address:
UNIT 201
Provider Business Mailing Address City Name:
BEL AIR
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-324-5660
Provider Business Mailing Address Fax Number:
410-420-9641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206 S. HAYS ST.
Provider Second Line Business Practice Location Address:
UNIT 201
Provider Business Practice Location Address City Name:
BEL AIR
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-324-5660
Provider Business Practice Location Address Fax Number:
410-420-9641
Provider Enumeration Date:
09/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BENALCAZAR
Authorized Official First Name:
HUGO
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-900-1909

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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