Organization
ADVANCED SURGICAL INSTITUTE P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCO V CANULLA MD (OWNER PRESIDENT)
(623) 584-4882
Entity
Organization
Contact information
Practice address
14510 W SHUMWAY DR, SUITE 201, SUN CITY WEST, AZ 85375-5814
(623) 584-4882
(623) 584-6732
Mailing address
14510 W SHUMWAY DR, SUITE 201, SUN CITY WEST, AZ 85375-5814
(623) 584-4882
(623) 584-6732
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
24230
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348583
—
AZ
Enumeration date
07/30/2006
Last updated
05/16/2013
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