Healthcare Provider Details

I. General information

NPI: 1679335467
Provider Name (Legal Business Name): RL SURGICAL ASSISTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3236 GRASSHOPPER DR SW
ALBUQUERQUE NM
87121-9100
US

IV. Provider business mailing address

3236 GRASSHOPPER DR SW
ALBUQUERQUE NM
87121-9100
US

V. Phone/Fax

Practice location:
  • Phone: 505-249-5586
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: REBECCA LUJAN
Title or Position: OWNER
Credential:
Phone: 505-249-5586