Provider Demographics
NPI:1407004229
Name:THE PLASTIC SURGERY CENTER AT KIERLAND
Entity Type:Organization
Organization Name:THE PLASTIC SURGERY CENTER AT KIERLAND
Other - Org Name:THE CANIGLIA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CANIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-483-6200
Mailing Address - Street 1:7102 E ACOMA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2771
Mailing Address - Country:US
Mailing Address - Phone:480-483-6200
Mailing Address - Fax:
Practice Address - Street 1:7102 E ACOMA DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2771
Practice Address - Country:US
Practice Address - Phone:480-483-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMD21593261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical