Provider Demographics
NPI:1164267746
Name:GC SURGICAL LLC
Entity type:Organization
Organization Name:GC SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAROLINI
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:305-799-7500
Mailing Address - Street 1:12361 HAGEN RANCH RD # 5032068
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-4174
Mailing Address - Country:US
Mailing Address - Phone:305-799-7500
Mailing Address - Fax:561-516-6538
Practice Address - Street 1:12361 HAGEN RANCH RD # 5032068
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-4174
Practice Address - Country:US
Practice Address - Phone:305-799-7500
Practice Address - Fax:561-516-6538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty