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General NPI Number Information
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NPI Number | 1184218935
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Entity Type | Organization
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Legal Business Name | SANO SURGERY LLC
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 1236 E 25TH ST
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City | TULSA
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State | OK
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Zip | 74114-2616
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Country | US
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Telephone | 602-777-0101
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Fax | 844-722-9329
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Provider Business Mailing Address
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Address Line | 3219 E CAMELBACK RD STE 249
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City | PHOENIX
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State | AZ
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Zip | 85018-2307
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Country | US
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Telephone | 602-777-0101
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Fax | 844-722-9329
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Authorized Official
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Title or Position | OWNER
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Name | MR. NIELS DUTCH ROJAS
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Credential |
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Telephone | 602-777-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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