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General NPI Number Information
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NPI Number | 1215489182
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Entity Type | Organization
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Legal Business Name | CORONADO SURGERY CENTER LLC
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 150 S. CORONADO DR SUITE 100
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City | SIERRA VISTA
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State | AZ
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Zip | 85635
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Country | US
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Telephone | 520-335-8450
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Fax | 520-335-8082
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Provider Business Mailing Address
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Address Line | 150 S. CORONADO DR SUITE 100
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City | SIERRA VISTA
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State | AZ
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Zip | 85635
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Country | US
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Telephone | 520-335-8450
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Fax | 520-335-8082
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Authorized Official
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Title or Position | DIRECTOR OF NURSING/ADMINISTRATION
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Name | DEBORAH M. ROCAS
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Credential | RN
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Telephone | 520-335-8450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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