Healthcare Provider Details

I. General information

NPI: 1891536991
Provider Name (Legal Business Name): AVON SURGICAL CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10825 W MCDOWELL RD STE 320
AVONDALE AZ
85392-5228
US

IV. Provider business mailing address

PO BOX 5068
SUN CITY WEST AZ
85376-5068
US

V. Phone/Fax

Practice location:
  • Phone: 520-278-5199
  • Fax:
Mailing address:
  • Phone: 623-777-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER SPENCER
Title or Position: ADMINISTRATOR
Credential:
Phone: 602-435-5172