Riverside Surgical and Weight Loss Center,LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD89469 Issued in FL

Legal business name

RIVERSIDE SURGICAL AND WEIGHT LOSS CENTER,LLC

Practice address

705 Sebastian Blvd
Suite D
Sebastian, FL 32958-4397

Phone

(772) 581-8003

Fax

(772) 581-8005

NPI assigned

Jan 27, 2009

Last updated

May 7, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Patrick W Domkowski, MD, PHD,FACS

Title

President

Phone

(772) 581-8003

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edgard Chavez, M.D.

  • Internal Medicine Physician
  • Sebastian, FL
  • NPI 1689817843
  NPD (past)
• Katiusca Chavez, M.D.

  • Internal Medicine Physician
  • Sebastian, FL
  • NPI 1235388307
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241654400000",
    "number": "1437397544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 SEBASTIAN BLVD.",
            "address_2": "SUITE D",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "32958",
            "telephone_number": "772-581-8003",
            "fax_number": "772-581-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 SEBASTIAN BLVD",
            "address_2": "SUITE D",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329584397",
            "telephone_number": "772-581-8003",
            "fax_number": "772-581-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE SURGICAL AND WEIGHT LOSS CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-27",
        "last_updated": "2009-05-07",
        "status": "A",
        "authorized_official_last_name": "DOMKOWSKI",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-581-8003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD,FACS"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "MD89469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverside Dental
• Riverside Dental Arts PLLC
• Riverside Eye Center PLLC (Riverside Eye Center)
• Riverside Family Dental, P.a.
• Riverside Surgery Center Inc
• Riverview Family Dental, PLLC
• Mohammad Nasir Rizwi, M.D.
• Roberta S Rose DO
• Brittany Robinson, RDN, LD/N
• Linda Jeanne Roch, RD, LDN

• Surgery Physician in Sebastian, FL
• Providers in Sebastian, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.