MEDICARE: GIARDINA SPORTSMEDICINE CONSULTANTS, INC.

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1578328118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIARDINA SPORTSMEDICINE CONSULTANTS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 71846
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-1015
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	34975 N NORTH VALLEY PKWY STE 118
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-4029
Country	:	US
Telephone Number	:	623-434-4361
Fax Number	:	623-434-4627

Authorized Official
Title or Position	:	OWNER
Name	:	DREW GIARDINA
Credential	:
Telephone Number	:	602-499-1139

Provider Enumeration Date	:	02/13/2024
Last Update Date	:	05/02/2024

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