Provider Demographics
NPI:1952736928
Name:PHOENIX SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:PHOENIX SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCESANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-674-2255
Mailing Address - Street 1:3 SW 129TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1775
Mailing Address - Country:US
Mailing Address - Phone:954-674-2255
Mailing Address - Fax:
Practice Address - Street 1:3 SW 129TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1775
Practice Address - Country:US
Practice Address - Phone:954-674-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAUTIFUL VISION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical