Provider Demographics
NPI:1396356960
Name:AFTER HOURS SURGICAL CARE LLC
Entity Type:Organization
Organization Name:AFTER HOURS SURGICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:FARESI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-465-4583
Mailing Address - Street 1:11766 FOXBRIAR LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-7830
Mailing Address - Country:US
Mailing Address - Phone:606-465-4583
Mailing Address - Fax:
Practice Address - Street 1:11766 FOXBRIAR LAKE TRL
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33473-7830
Practice Address - Country:US
Practice Address - Phone:606-465-4583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty