FORTITUDE SURGERY CENTER LLC NPI 1043789118

NPI Information

  • NPI: 1043789118
  • Provider Name: FORTITUDE SURGERY CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 03D2163922
  • Address: 5133 N CENTRAL AVE STE 200
    PHOENIX, AZ
    ZIP 85012
  • Phone: (602) 651-1380

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NPI Details

FORTITUDE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Phoenix, AZ. FORTITUDE SURGERY CENTER, LLC NPI is 1043789118. The provider is registered as an organization entity type.

The provider's business location address is:

5133 N CENTRAL AVE STE 200
PHOENIX, AZ
ZIP 85012-438
Phone: (602) 651-1380

The provider's authorized official is Nikki Vaughan .
The authorized official title is Administrator and has the following contact phone number (602) 651-1380.

The CLIA number assigned to this NPI record is 03D2163922 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/19/2018 and was last updated on 10/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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