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General NPI Number Information
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NPI Number | 1720284110
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Entity Type | Organization
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Legal Business Name | ARIZONA PLASTIC SURGERY INSTITUTE
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5750 W THUNDERBIRD RD F650
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City | GLENDALE
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State | AZ
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Zip | 85306-4660
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Country | US
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Telephone | 602-547-2774
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Fax | 602-547-2776
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Provider Business Mailing Address
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Address Line | 5750 W THUNDERBIRD RD F650
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City | GLENDALE
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State | AZ
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Zip | 85306-4660
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Country | US
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Telephone | 602-547-2774
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Fax | 602-547-2776
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAMON A ROBLES
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Credential | M.D.
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Telephone | 602-547-2774
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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 | 24120
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License Number State | AZ
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