MEDICARE: AQUARIUS SURGICAL CONSULTING SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086X0206X	Surgical Oncology Physician

General Provider Information

NPI Number	:	1821929159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AQUARIUS SURGICAL CONSULTING SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 2280
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92244-2280
Country	:	US
Telephone Number	:	760-460-6425
Fax Number	:	760-332-4800

Provider Business Practice Location Address
First Line	:	1503 N IMPERIAL AVE STE 105
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92243-6302
Country	:	US
Telephone Number	:	760-693-5372
Fax Number	:	760-693-5375

Authorized Official
Title or Position	:	COO
Name	:	JULIE FLORES
Credential	:
Telephone Number	:	760-460-6425

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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