Provider Demographics
NPI:1285927574
Name:PARA SURGICAL SPECIALISTS, PLLC
Entity type:Organization
Organization Name:PARA SURGICAL SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:623-247-4900
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:85037-0000
Mailing Address - Country:US
Mailing Address - Phone:623-247-4900
Mailing Address - Fax:623-247-4908
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:85037-0000
Practice Address - Country:US
Practice Address - Phone:623-247-4900
Practice Address - Fax:623-247-4908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ022450208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF84923Medicare UPIN
AZZ147649Medicare PIN