Provider Demographics
NPI:1275256562
Name:CARDIOVASCULAR ASSOCIATES SURGERY AND ELECTROPHYSIOLOGY LLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES SURGERY AND ELECTROPHYSIOLOGY LLC
Other - Org Name:CARDIOVASCULAR ASSOCIATES SURGERY AND ELECTROPHYSIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-450-6069
Mailing Address - Street 1:4838 E BASELINE RD STE 108
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4672
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4838 E BASELINE RD STE 108
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4672
Practice Address - Country:US
Practice Address - Phone:480-450-6069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical