Provider Demographics
NPI:1447979752
Name:CRC SURGICAL LLC
Entity type:Organization
Organization Name:CRC SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUSHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:352-559-1200
Mailing Address - Street 1:3426 NW 43RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-8156
Mailing Address - Country:US
Mailing Address - Phone:352-559-1200
Mailing Address - Fax:352-559-1210
Practice Address - Street 1:3426 NW 43RD ST STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-8156
Practice Address - Country:US
Practice Address - Phone:352-559-1200
Practice Address - Fax:352-559-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty