Organization
FORTITUDE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI VAUGHAN RN (ADMINISTRATOR)
(602) 651-1380
Entity
Organization
Contact information
Practice address
5133 N CENTRAL AVE STE 200, PHOENIX, AZ 85012-1438
(602) 651-1380
Mailing address
5133 N CENTRAL AVE STE 200, PHOENIX, AZ 85012-1438
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/19/2018
Last updated
10/30/2019
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