Provider Demographics
NPI:1962190793
Name:THE SURGERY CLINICS LLC
Entity type:Organization
Organization Name:THE SURGERY CLINICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUESO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-251-0070
Mailing Address - Street 1:15001 SHADY GROVE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6354
Mailing Address - Country:US
Mailing Address - Phone:240-912-4576
Mailing Address - Fax:301-251-0071
Practice Address - Street 1:20528 BOLAND FARM RD STE 210
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4038
Practice Address - Country:US
Practice Address - Phone:240-912-4576
Practice Address - Fax:301-251-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty