MEDICARE: ARIZONA SURGICAL SPECIALISTS CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1174307961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA SURGICAL SPECIALISTS CENTER, LLC

Provider Business Mailing Address
First Line	:	9401 W THUNDERBIRD RD STE 180
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85381-4210
Country	:	US
Telephone Number	:	623-516-8252
Fax Number	:	623-516-8253

Provider Business Practice Location Address
First Line	:	6442 E SPEEDWAY BLVD STE 152
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-0013
Country	:	US
Telephone Number	:	520-525-5491
Fax Number	:	623-691-8498

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVEN SIWEK
Credential	:	MD
Telephone Number	:	623-516-8252

Provider Enumeration Date	:	08/22/2023
Last Update Date	:	03/28/2025

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