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Organization
COSMETIC SURGERY FACILITY LLC
Active
Organization
COSMETIC SURGERY FACILITY LLC
Active
Other names
CosmeticSurg.net
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO L RODRIGUEZ M.D. (MEDICAL DIRECTOR)
(410) 494-8100
Entity
Organization
Contact information
Practice address
1300 BELLONA AVE, SUITE C, LUTHERVILLE TIMONIUM, MD 21093-5465
(410) 494-8100
(410) 494-0815
Mailing address
1300 BELLONA AVE, SUITE C, LUTHERVILLE TIMONIUM, MD 21093-5465
(410) 494-8100
(410) 494-0815
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
D41395
MD
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1462
MD
261QA1903X
Ambulatory Surgical Clinic/Center
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Other
Enumeration date
07/22/2007
Last updated
04/15/2014
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