MEDICARE: EL SOL FAMILY MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	21943	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316001209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL SOL FAMILY MEDICINE PC

Provider Business Mailing Address
First Line	:	2260 N ROSEMONT BLVD
Second Line	:	STE 107
City	:	TUCSON
State	:	AZ
Zip	:	85712-2137
Country	:	US
Telephone Number	:	520-318-1033
Fax Number	:

Provider Business Practice Location Address
First Line	:	2260 N ROSEMONT BLVD
Second Line	:	STE 107
City	:	TUCSON
State	:	AZ
Zip	:	85712-2137
Country	:	US
Telephone Number	:	520-318-1033
Fax Number	:	520-318-1338

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MELISSA D LEVINE
Credential	:	MD
Telephone Number	:	520-318-1033

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	01/14/2008

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Directions to “EL SOL FAMILY MEDICINE PC ” Practice Location

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