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Organization

MODERN SURGICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ATHANASIOS MANOLE (OWNER)
(505) 319-0231
Entity
Organization

Contact information

Practice address
2500 LOUISIANA BLVD NE STE 600, ALBUQUERQUE, NM 87110-4372
(505) 319-0231
Mailing address
1540 JUAN TABO BLVD NE STE A, ALBUQUERQUE, NM 87112-4460
(505) 800-7246

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
04/22/2026
Last updated
04/22/2026
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