Provider Demographics
NPI:1184218935
Name:SANO SURGERY LLC
Entity Type:Organization
Organization Name:SANO SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NIELS
Authorized Official - Middle Name:DUTCH
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-777-0101
Mailing Address - Street 1:3219 E CAMELBACK RD STE 249
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2307
Mailing Address - Country:US
Mailing Address - Phone:602-777-0101
Mailing Address - Fax:844-722-9329
Practice Address - Street 1:1236 E 25TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-2616
Practice Address - Country:US
Practice Address - Phone:602-777-0101
Practice Address - Fax:844-722-9329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No302F00000XManaged Care OrganizationsExclusive Provider Organization