Provider Demographics
NPI:1710201538
Name:DUBLIN SURGERY CENTER LLC
Entity Type:Organization
Organization Name:DUBLIN SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIGO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-932-9548
Mailing Address - Street 1:5005 PARKCENTER AVE
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3582
Mailing Address - Country:US
Mailing Address - Phone:614-932-9548
Mailing Address - Fax:614-932-9549
Practice Address - Street 1:5005 PARKCENTER AVE
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3582
Practice Address - Country:US
Practice Address - Phone:614-932-9548
Practice Address - Fax:614-932-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0731AS261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical