Organization
SOUTH MOUNTAIN SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BURROLA (GENERAL MANAGER)
(623) 302-0850
Entity
Organization
Contact information
Practice address
15810 S 45TH ST STE 150, PHOENIX, AZ 85048-7655
(480) 747-6240
(480) 747-6238
Mailing address
15810 S 45TH ST STE 150, PHOENIX, AZ 85048-7655
(480) 747-6240
(480) 747-6238
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/15/2018
Last updated
01/22/2019
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