Provider Demographics
NPI:1447645072
Name:ESPRIT SURGERY CENTER, LLC
Entity type:Organization
Organization Name:ESPRIT SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:COLEMAN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:303-792-2828
Mailing Address - Street 1:10375 PARK MEADOWS DR
Mailing Address - Street 2:SUITE 150B
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-6735
Mailing Address - Country:US
Mailing Address - Phone:303-792-2828
Mailing Address - Fax:303-792-3328
Practice Address - Street 1:10375 PARK MEADOWS DR
Practice Address - Street 2:SUITE 150B
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6735
Practice Address - Country:US
Practice Address - Phone:303-792-2828
Practice Address - Fax:303-792-3328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16K184261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical