=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245820042
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALOE SURGICAL CENTER SCOTTSDALE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2021
-----------------------------------------------------
Last Update Date | 09/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9700 N 91ST ST STE C100 SUITE C100
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85258-5054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-533-2161
-----------------------------------------------------
Fax | 602-532-7825
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9700 N 91ST ST STE C100
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85258-5054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-533-2161
-----------------------------------------------------
Fax | 602-532-7825
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MARKET PRESIDENT
-----------------------------------------------------
Name | ERIC BOON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 480-567-0269
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------