MEDICARE: MIRTHA FELIX

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	310400000X	Assisted Living Facility	AL10093H	AZ

General Provider Information

NPI Number	:	1831638394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRTHA FELIX

Provider Business Mailing Address
First Line	:	6301 W EARLL DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-5717
Country	:	US
Telephone Number	:	480-233-6481
Fax Number	:	623-398-8909

Provider Business Practice Location Address
First Line	:	6301 W EARLL DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-5717
Country	:	US
Telephone Number	:	480-233-6481
Fax Number	:	623-398-8909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2017
Last Update Date	:	02/16/2017

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Directions to “ MIRTHA FELIX ” Practice Location

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