Basic Information
| Provider Information | |||||||||
| NPI: | 1104366616 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSIST AT EASE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4201 | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334424201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542745619 | ||||||||
| FaxNumber: | 7542275792 | ||||||||
| Practice Location | |||||||||
| Address1: | 3467 W HILLSBORO BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334429473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542745619 | ||||||||
| FaxNumber: | 7542275792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2017 | ||||||||
| LastUpdateDate: | 12/18/2019 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | BRICKLIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9542745619 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/18/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.