Healthcare Provider Details

I. General information

NPI: 1285927574
Provider Name (Legal Business Name): PARA SURGICAL SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 03/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9515 W. CAMELBACK RD SUITE 132
PHOENIX AZ
85037-0000
US

IV. Provider business mailing address

9515 W. CAMELBACK RD SUITE 132
PHOENIX AZ
85037-0000
US

V. Phone/Fax

Practice location:
  • Phone: 623-247-4900
  • Fax: 623-247-4908
Mailing address:
  • Phone: 623-247-4900
  • Fax: 623-247-4908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number022450
License Number StateAZ

VIII. Authorized Official

Name: DR. DANIEL JOHN PARA
Title or Position: PHYSICIAN/OWNER
Credential: MD, FACS
Phone: 623-247-4900