Provider Demographics
NPI:1275384380
Name:ROCK SURGICAL LLC
Entity Type:Organization
Organization Name:ROCK SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL FIRST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES-STUDNICKA
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:708-514-1788
Mailing Address - Street 1:160 FIELDSTONE FARMS DR
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276-6713
Mailing Address - Country:US
Mailing Address - Phone:708-514-1788
Mailing Address - Fax:
Practice Address - Street 1:160 FIELDSTONE FARMS DR
Practice Address - Street 2:
Practice Address - City:SENOIA
Practice Address - State:GA
Practice Address - Zip Code:30276-6713
Practice Address - Country:US
Practice Address - Phone:708-514-1788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty