Organization
ATLANTA SURGERY GROUP SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO LUQUE CSA-FA (PRESIDENT)
(404) 668-6112
Entity
Organization
Contact information
Practice address
4088 JONES BRIDGE CIR, NORCROSS, GA 30092-1214
(404) 668-6112
Mailing address
PO BOX 11512, ATLANTA, GA 30355-1512
(404) 668-6112
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
08/29/2007
Last updated
08/20/2012
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