R Derosa Surgery LLC

NPI #1871209494 in Glendale, Arizona

Provider Information

NPI Number: 1871209494
Entity Type: Organization
Organization Name: R Derosa Surgery LLC
Primary Specialty: Surgery
Enumeration Date: Jan 26, 2023
Last Updated: Jan 26, 2023

Practice Location

Address: 18701 N 67TH AVE
City: Glendale
State: Arizona
ZIP Code: 85308-7100
Phone: (623) 561-1000

Authorized Official

Name: RICHARD DEROSA, MD
Title: OWNER
Phone: (703) 975-9847

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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