# PINE SURGICAL INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pine Surgical Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760074744
- **Authorized official:** BRANDIE HERNANDEZ (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (480) 204-4593

## Contact information

- **Practice address:** 10375 PARK MEADOWS DR STE 150, LONE TREE, CO 80124-6755
- **Practice address phone:** (480) 204-4593
- **Mailing address:** 10375 PARK MEADOWS DR STE 150, LONE TREE, CO 80124-6755
- **Mailing address phone:** (480) 204-4593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/10/2021
- **Last updated:** 02/10/2021