Specialtycare | |
9305 W Thomas Rd Suite 290 Phoenix AZ 85037-3328 | |
(602) 288-9719 | |
Not Available |
Full Name | Specialtycare |
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Speciality | Pediatrics |
Location | 9305 W Thomas Rd, Phoenix, Arizona |
Authorized Official Name and Position | Alicia Acevedo-urcuyo (PRESIDENT) |
Authorized Official Contact | 6022889719 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Specialtycare 9305 W Thomas Rd Suite 290 Phoenix AZ 85037-3328 Ph: (602) 288-9719 | Specialtycare 9305 W Thomas Rd Suite 290 Phoenix AZ 85037-3328 Ph: (602) 288-9719 |
NPI Number | 1801926175 |
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Provider Enumeration Date | 03/06/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 8426021916 |
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Medicare Enrollment ID | O20040813000395 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801926175 | NPI | - | NPPES |
870859 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Arizona) | Primary |
208000000X | Pediatrics | (Arizona) | Primary |
Provider Name | Alicia Acevedo-urcuyo |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1841226644 PECOS PAC ID: 9032182522 Enrollment ID: I20040816000887 |
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