Organization Active NPI

Palm Beach First Assist, LLC

  • Surgical Physician Assistant
  • Melbourne, FL
National Provider Identifier
1053647982
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
PALM BEACH FIRST ASSIST, LLC
Practice address
1600 Sarno Road
Suite 15
Melbourne, FL 32935
Phone
(800) 348-4565
Fax
(321) 610-5115
NPI assigned
Oct 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jeffrey T Gray
Title
Cfo & Treasurer
Phone
(615) 345-5550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

1600 Sarno Road
Suite 15
Melbourne, FL 32935

Mailing address

3 Maryland Farms Ste 200
Brentwood, TN 37027-5780
Phone (615) 345-5450

Other names 1

  • PALM BEACH FIRST ASSIST LLC Other name

National Provider Directory

National Provider Directory

Locations

1600 Sarno Rd
Ste 15
Melbourne, FL 32935
Phone (800) 345-4565

6767 N Wickham Rd
Ste A213
Melbourne, FL 32940

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1053647982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARYLAND FARMS STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275780",
            "telephone_number": "615-345-5450",
            "fax_number": "615-345-5365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SARNO ROAD",
            "address_2": "SUITE 15",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "800-348-4565",
            "fax_number": "321-610-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH FIRST ASSIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-28",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO & TREASURER",
        "authorized_official_telephone_number": "615-345-5550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALM BEACH FIRST ASSIST LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PALM BEACH FIRST ASSIST LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.