| Organization Name: | COSMETIC SURGERY FACILITY LLC |
| NPI Number: | 1578763199 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICARDO L RODRIGUEZ (MEDICAL DIRECTOR) |
| Mailing Address: | 1300 Bellona Ave Suite C Lutherville Timonium |
| State: | MD US |
| Postal Code: | 210935465 |
| Phone Number: | 4104948100 |
| Fax Number: | 4104940815 |
| NPI Enumeration Date: | 07/22/2007 |
| NPI Last Update Date: | 04/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |