Organization
GWINNETT SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE J. HERNANDEZ (CCO)
(404) 851-6378
Entity
Organization
Contact information
Practice address
631 PROFESSIONAL DR, SUITE 300, LAWRENCEVILLE, GA 30046-3367
(770) 962-9977
(770) 339-9804
Mailing address
631 PROFESSIONAL DR, SUITE 390, LAWRENCEVILLE, GA 30046-3367
(770) 962-9977
(770) 339-9804
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
10041103
GA
Other
Enumeration date
11/24/2010
Last updated
10/12/2019
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