Organization
SREC EYE SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TILLIE ANDRADE (CREDENTIALING SPECIALIST)
(702) 449-9173
Entity
Organization
Contact information
Practice address
9954 N MAIN ST UNIT 2, BERLIN, MD 21811-1299
(443) 242-4070
Mailing address
9954 N MAIN ST UNIT 2, BERLIN, MD 21811-1299
(443) 242-4070
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
Other
Enumeration date
07/16/2025
Last updated
07/17/2025
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