MEDICARE: SUNRISE FLAMINGO SURGERY 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	465ASC9	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295798346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE FLAMINGO SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	2565 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5203
Country	:	US
Telephone Number	:	702-697-7900
Fax Number	:	702-796-6250

Provider Business Practice Location Address
First Line	:	2565 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5203
Country	:	US
Telephone Number	:	702-697-7900
Fax Number	:	702-796-6250

Authorized Official
Title or Position	:	VP
Name	:	WILLIAM GREGORY SWINNEY
Credential	:
Telephone Number	:	972-789-2877

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	01/31/2023

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Directions to “SUNRISE FLAMINGO SURGERY CENTER, LLC ” Practice Location

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