DESERT MIRAGE SURGERY CENTER, LLC (NPI# 1881216372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881216372 |
Entity Type | Organization |
Organization Name | DESERT MIRAGE SURGERY CENTER, LLC |
Practice Address |
12361 W Bola Dr Ste 112 Surprise AZ 85378-9021 |
Mailing Address |
Po Box 41638 Phoenix AZ 85080-1638 |
Practice Telephone | 8449002567 |
Mailing Telephone | 6028994404 |
Enumeration Date | 2020-05-07 |
Last Update Date | 2020-05-07 |
Authorized Official Name | TIMOTHY COZATT (INVESTOR RELATIONS OFFICER) |
Authorized Official Telephone | 6028994404 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
Street Address |
12361 W BOLA DR STE 112 |
City | SURPRISE |
State | AZ |
Zip Code | 85378-9021 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780205294 | National Cardiovascular Surgery Center of Surprise, LLC | Clinic/Center | 12361 W Bola Dr Ste 112, Surprise, AZ 85378-9021 | 2020-05-06 |
1003438573 | National Cardiovascular Institute of Surprise, LLC | Clinic/Center | 12361 W Bola Dr Ste 112, Surprise, AZ 85378-9021 | 2020-05-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467947101 | Destiny Springs Healthcare, LLC | Psychiatric Hospital | 17300 N. Dysart Road, Surprise, AZ 85378 | 2018-06-26 |
1881013480 | Amanda Brimlow | Specialist | 12425 West Bell Rd, Suite 200, Surprise, AZ 85378 | 2014-04-10 |
1598193104 | Kalin Marie Harding | Nurse Practitioner | 12425 W. Bell Rd., Suite 106, Suprise, AZ 85378 | 2013-10-16 |
1043651540 | Rachel Sara Herrin | Internal Medicine | 12665 W. Smokey Dr., #140, Surprise, AZ 85378 | 2013-07-12 |
1962756528 | Daniel Allen Dryer | Registered Nurse | 11607 W. Mingus Mt. Ct., Surprise, AZ 85378 | 2012-11-05 |
1124374715 | Rabeca Vatamaniuc | Home Health Aide | 11151 W Lily Mckinley Dr, Surprise, AZ 85378 | 2012-08-01 |
1710073457 | Arizona's Children Association | Clinic/Center | 11321 West Bell Road, Suite 401, Surprise, AZ 85378 | 2006-10-04 |
1538429121 | Sr Billing | Anesthesiology | 12361 W Bola Dr, Suite 109, Surprise, AZ 85378 | 2012-05-17 |
1457515579 | Madhuri Dhupati & Associates Md PC. | Clinic/Center | 12647 W Smokey Dr Ste 119, Surprise, AZ 85378 | 2008-07-17 |
1205267119 | Post-acute Physicians of Arizona Pllc | Physical Medicine & Rehabilitation | 13060 W Bell Rd, Surprise, AZ 85378-1200 | 2013-12-02 |
Find all providers in zip 85378 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780205294 | National Cardiovascular Surgery Center of Surprise, LLC | Clinic/Center | 12361 W Bola Dr Ste 112, Surprise, AZ 85378-9021 | 2020-05-06 |
1073155834 | Regency Ambulatory Surgery Center One, LLC | Clinic/Center | 14753 W Mountain View Blvd, Surprise, AZ 85374 | 2019-10-14 |
1164064929 | Advanced Ambulatory Surgery Center One, LLC | Clinic/Center | 14753 W. Mountain View Blvd., Surprise, AZ 85374 | 2019-10-14 |
1679079339 | Surprise Facility Group, LLC | Clinic/Center | 16960 W Bell Rd Ste 502, Surprise, AZ 85374-8946 | 2018-04-02 |
1932644606 | Innovative Surgery Center LLC | Clinic/Center | 15547 N Reems Rd Bldg A, Surprise, AZ 85374-9583 | 2017-01-04 |
1710509880 | Advanced Ambulatory Surgery Center One, LLC | Clinic/Center | 14753 W Mountain View Blvd, Surprise, AZ 85374 | 2020-05-12 |
1003438573 | National Cardiovascular Institute of Surprise, LLC | Clinic/Center | 12361 W Bola Dr Ste 112, Surprise, AZ 85378-9021 | 2020-05-07 |
1740683762 | Reems Surgery Center LLC | Clinic/Center | 15571 N Reems Rd, Surprise, AZ 85374-9584 | 2014-10-04 |
1376819300 | Prime Meridian Investment Group | Clinic/Center | 15571 N Reems Rd, Surprise, AZ 85374-9584 | 2012-03-23 |
1013195569 | Sun City West Surgery Center, LLC | Clinic/Center | 12361 W Bola Dr, Suite 112, Surprise, AZ 85374-9019 | 2008-02-07 |
Find all providers in SURPRISE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.