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General NPI Number Information
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NPI Number | 1396356960
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Entity Type | Organization
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Legal Business Name | AFTER HOURS SURGICAL CARE LLC
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Dates
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Enumeration Date | 08/16/2020
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Last Update Date | 08/16/2020
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Provider Practice Location Address
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Address Line | 11766 FOXBRIAR LAKE TRL
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City | BOYNTON BEACH
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State | FL
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Zip | 33473-7830
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Country | US
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Telephone | 606-465-4583
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Fax |
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Provider Business Mailing Address
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Address Line | 11766 FOXBRIAR LAKE TRL
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City | BOYNTON BEACH
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State | FL
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Zip | 33473-7830
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Country | US
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Telephone | 606-465-4583
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIANO FARESI
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Credential | MD
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Telephone | 606-465-4583
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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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