NPIMap

Organization Active NPI

Physician Assistant Services of Florida LLC

  • Surgical Physician Assistant
  • Melbourne, FL
National Provider Identifier
1972673184
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA3525 Issued in FL
Legal business name
PHYSICIAN ASSISTANT SERVICES OF FLORIDA LLC
Practice address
301 E Hibiscus Blvd
Melbourne, FL 32901-3105
Phone
(321) 409-8941
Fax
(321) 409-9392
NPI assigned
Nov 8, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Charles Hamilton Boone, PA-C
Title
Owner
Phone
(321) 409-8941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA3525 FL Primary

Addresses

Primary practice location

301 E Hibiscus Blvd
Melbourne, FL 32901-3105

Mailing address

PO Box 1261
Melbourne, FL 32902-1261
Phone (321) 409-8941

National Provider Directory

National Provider Directory

Locations

301 E Hibiscus Blvd
Melbourne, FL 32901
Phone (321) 409-8941

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1972673184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1261",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021261",
            "telephone_number": "321-409-8941",
            "fax_number": "321-409-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013105",
            "telephone_number": "321-409-8941",
            "fax_number": "321-409-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ASSISTANT SERVICES OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HAMILTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-409-8941",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA3525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 20, 2008; 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.