Provider Demographics
NPI:1447875968
Name:AQ SURGERY LLC
Entity type:Organization
Organization Name:AQ SURGERY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANASTASIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIMBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:561-202-1070
Mailing Address - Street 1:1411 N FLAGLER DR STE 7600
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3419
Mailing Address - Country:US
Mailing Address - Phone:561-202-1070
Mailing Address - Fax:561-202-1075
Practice Address - Street 1:1411 N FLAGLER DR STE 7600
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3419
Practice Address - Country:US
Practice Address - Phone:561-202-1070
Practice Address - Fax:561-202-1075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
No261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial SurgeryGroup - Single Specialty