Provider Demographics
NPI:1124428875
Name:ARIZONA CENTRAL SURGICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:ARIZONA CENTRAL SURGICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONINO
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAMMARATA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:623-341-1604
Mailing Address - Street 1:9515 W CAMELBACK RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-1355
Mailing Address - Country:US
Mailing Address - Phone:623-247-4900
Mailing Address - Fax:
Practice Address - Street 1:9515 W CAMELBACK RD
Practice Address - Street 2:SUITE 132
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-1355
Practice Address - Country:US
Practice Address - Phone:623-247-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-31
Last Update Date:2014-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005651208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty