Dock and Roll LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

DOCK AND ROLL LLC

Practice address

6211 NW 34TH Ave
Fort Lauderdale, FL 33309-1602

Phone

(954) 369-8508

NPI assigned

Jun 20, 2016

Last updated

Jun 20, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra Lynn Freymuth, CSFANPI 1265805386

Title

Csfa

Phone

(954) 369-8508

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sandra Lynn Freymuth, CSFA

  • Surgical Physician Assistant
  • Fort Lauderdale, FL
  • NPI 1265805386
  Authorized official Same address or phone

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1235589334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 NW 34TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091602",
            "telephone_number": "954-369-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 NW 34TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091602",
            "telephone_number": "954-369-8508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCK AND ROLL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "FREYMUTH",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CSFA",
        "authorized_official_telephone_number": "954-369-8508",
        "authorized_official_credential": "CSFA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.