Provider Demographics
NPI:1194052753
Name:MILWAUKEE SURGICAL SPECIALISTS SC
Entity type:Organization
Organization Name:MILWAUKEE SURGICAL SPECIALISTS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CABALLERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-761-3100
Mailing Address - Street 1:10850 W PARK PL
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-3606
Mailing Address - Country:US
Mailing Address - Phone:414-359-5721
Mailing Address - Fax:414-359-5703
Practice Address - Street 1:3111 W RAWSON AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9417
Practice Address - Country:US
Practice Address - Phone:414-761-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty