MEDICARE: ARIZONA UVC MEDICAL PLLC

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	208600000X	Surgery Physician
2	2086S0129X	Vascular Surgery Physician

General Provider Information

NPI Number	:	1548800980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA UVC MEDICAL PLLC

Provider Business Mailing Address
First Line	:	3820 NORTHDALE BLVD STE 201
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1893
Country	:	US
Telephone Number	:	800-991-6117
Fax Number	:	813-434-2023

Provider Business Practice Location Address
First Line	:	1010 E MCDOWELL RD STE 103
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2607
Country	:	US
Telephone Number	:	800-991-6117
Fax Number	:	888-812-8191

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	KEVIN MCGOVERN
Credential	:
Telephone Number	:	800-991-6117

Provider Enumeration Date	:	01/14/2020
Last Update Date	:	05/15/2026

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