Organization
SPECOPS SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEMETRIO JUAN AGUILA III MD (PRESIDENT / CEO)
(402) 370-8228
Entity
Organization
Contact information
Practice address
701 PINNACLE DR STE 107, PAPILLION, NE 68046-6228
(402) 370-8228
(402) 227-8245
Mailing address
PO BOX 460910, PAPILLION, NE 68046-0910
(402) 370-8228
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
207Y00000X
Otolaryngology Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
04/20/2020
Last updated
10/10/2023
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