# CORONADO SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235363987
- **Authorized official:** DONNA TRIBBLE RN, CNOR (ADMINISTRATOR/DON)
- **Authorized official phone:** (702) 589-9250

## Contact information

- **Practice address:** 2779 W HORIZON RIDGE PKWY, SUITE 140, HENDERSON, NV 89052-4184
- **Practice address phone:** (702) 589-9250
- **Practice address fax:** (702) 589-9257
- **Mailing address:** 2779 W HORIZON RIDGE PKWY, SUITE 140, HENDERSON, NV 89052-4184
- **Mailing address phone:** (702) 589-9250
- **Mailing address fax:** (702) 589-9257

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 5381ASC-0 | NV | Yes |

## Other

- **Enumeration date:** 05/11/2009
- **Last updated:** 05/10/2019