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General NPI Number Information
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NPI Number | 1134935646
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Entity Type | Organization
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Legal Business Name | ELITECARE SURGICAL SPECIALISTS LLC
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 3200 TOWER OAKS BLVD STE 140
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City | ROCKVILLE
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State | MD
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Zip | 20852-4216
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Country | US
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Telephone | 480-577-5694
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Fax |
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Provider Business Mailing Address
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Address Line | 39 STEPNEY LN UNIT 58
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City | EDGEWATER
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State | MD
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Zip | 21037-8503
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Country | US
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Telephone | 480-577-5694
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HAMID REZA ZAHIRI
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Credential | MD
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Telephone | 480-577-5694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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