Organization
R DEROSA SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD DEROSA MD (OWNER)
(703) 975-9847
Entity
Organization
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-1000
Mailing address
6225 E DUSTY COYOTE CIR, SCOTTSDALE, AZ 85266-7201
(703) 975-9847
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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