Provider Demographics
NPI:1861038655
Name:BIOLOGICS SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:BIOLOGICS SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTALINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-429-0404
Mailing Address - Street 1:4400 N SCOTTSDALE ROAD
Mailing Address - Street 2:SUITE 9 #844
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251
Mailing Address - Country:US
Mailing Address - Phone:602-429-0404
Mailing Address - Fax:480-603-3244
Practice Address - Street 1:8994 E DESERT COVE AVE STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7901
Practice Address - Country:US
Practice Address - Phone:602-429-0404
Practice Address - Fax:480-603-3244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty