AGAVE SURGICAL SERVICES LLC NPI 1477026862

NPI Information

NPI: 1477026862
Provider Name: AGAVE SURGICAL SERVICES LLC
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Organization

Specialization: Acute Care

Address:
2045 S VINEYARD STE 142
MESA, AZ
ZIP 85210
Phone: (480) 330-6010
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AGAVE SURGICAL SERVICES LLC is an acute care nurse practitioner in Mesa, AZ. AGAVE SURGICAL SERVICES LLC NPI is 1477026862. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2045 S VINEYARD STE 142
MESA, AZ
ZIP 85210-891
Phone: (480) 330-6010

The provider's authorized official is Bernadette Andalkar .
The authorized official title is Owner and has the following contact phone number (520) 490-8368.

The enumeration date for this NPI number is 1/8/2019 and was last updated on 1/8/2019.

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
1	363LA2100X	Nurse Practitioner	Acute Care			Yes

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: 4/28/2024

NPI Synchronization or Removal

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