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NPI Code Detail

MEDICARE: ANDREA PACHECO-AMARO

MEDICARE: ANDREA PACHECO-AMARO
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
12255A2300XAthletic Trainer
22255A2300XAthletic TrainerATR-100205AZ

General Provider Information

NPI Number : 1487426664
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA PACHECO-AMARO
Provider Business Mailing Address
First Line : 505 W BASELINE RD APT 1026
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1173
Country : US
Telephone Number : 626-802-8843
Fax Number :
Provider Business Practice Location Address
First Line : 1025 E BROADWAY RD STE 101
Second Line :
City : TEMPE
State : AZ
Zip : 85282-1535
Country : US
Telephone Number : 626-802-8843
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2023
Last Update Date : 07/10/2025

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Directions to “ ANDREA PACHECO-AMARO ” Practice Location

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