Organization · NPI-2

Dilorenzo Surgical Assisting

Physician Assistant, Surgical · Waycross, GA

NPI number1770177651
StatusActive
Last updated in NPPESJan 4, 2022

Details

NPI
1770177651
Entity type
Organization (NPI-2)
Legal business name
Dilorenzo Surgical Assisting
Organization subpart
No
Enumeration date
Feb 22, 2021
Certification date
Jan 3, 2022
Last updated
Jan 4, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AS0400X Physician Assistant, Surgical––Yes

Practice location

694 Saddle Cir
Waycross, GA 31503-7930

Phone 912-337-7789

Mailing address

694 Saddle Cir
Waycross, GA 31503-7930

Phone 912-337-7789

Authorized official

Penny Dilorenzo
Owner
9123377789

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physician Assistant, Surgical providers in Waycross, GA