Provider Demographics
NPI:1467635052
Name:SURGICAL BARIATRIC CENTERS, LLC
Entity Type:Organization
Organization Name:SURGICAL BARIATRIC CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-657-2263
Mailing Address - Street 1:508 S HABANA AVE
Mailing Address - Street 2:SUITE 335
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4181
Mailing Address - Country:US
Mailing Address - Phone:813-657-2263
Mailing Address - Fax:813-877-6002
Practice Address - Street 1:508 S HABANA AVE
Practice Address - Street 2:SUITE 335
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4181
Practice Address - Country:US
Practice Address - Phone:813-657-2263
Practice Address - Fax:813-877-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63020208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty