| Cerebro Wellness | |
|
2111 E Baseline Rd Ste F4 Tempe AZ 85283-1519 | |
| (602) 888-3474 | |
| (762) 212-4347 |
| Full Name | Cerebro Wellness |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2111 E Baseline Rd Ste F4, Tempe, Arizona |
| Authorized Official Name and Position | Bryan Keoke Lazaro (OWNER) |
| Authorized Official Contact | 6029042277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cerebro Wellness 5223 1/2 S 5th St Phoenix AZ 85040-8707 Ph: (602) 904-2277 | Cerebro Wellness 2111 E Baseline Rd Ste F4 Tempe AZ 85283-1519 Ph: (602) 888-3474 |
| NPI Number | 1629689922 |
|---|---|
| Provider Enumeration Date | 08/11/2020 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Medicare PECOS PAC ID | 4385018837 |
|---|---|
| Medicare Enrollment ID | O20230323001557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629689922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Bryan Lazaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912458845 PECOS PAC ID: 4880976521 Enrollment ID: I20170112003390 |
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