Organization
SURGICALIST OF AZ PLLC
Active
Parent organization
THE SURGICALIST GROUP PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE SURGICALIST GROUP PLLC
Authorized official
MIT DESAI MD (CEO)
(813) 530-5043
Entity
Organization
Contact information
Practice address
13555 W MCDOWELL RD STE 204, GOODYEAR, AZ 85395-2626
(623) 512-4326
Mailing address
PO BOX 21647, TAMPA, FL 33622-1647
(813) 530-5043
(813) 530-5043
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
03/01/2018
Last updated
09/29/2023
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