Provider Demographics
NPI:1134935646
Name:ELITECARE SURGICAL SPECIALISTS LLC
Entity type:Organization
Organization Name:ELITECARE SURGICAL SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:REZA
Authorized Official - Last Name:ZAHIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-577-5694
Mailing Address - Street 1:39 STEPNEY LN UNIT 58
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-8503
Mailing Address - Country:US
Mailing Address - Phone:480-577-5694
Mailing Address - Fax:
Practice Address - Street 1:3200 TOWER OAKS BLVD STE 140
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4216
Practice Address - Country:US
Practice Address - Phone:480-577-5694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty