Healthcare Provider Details

I. General information

NPI: 1457278020
Provider Name (Legal Business Name): MADISON MAURO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 E PECOS RD
CHANDLER AZ
85225-6077
US

IV. Provider business mailing address

2955 E TIE DOWN DR
SAN TAN VALLEY AZ
85140-1791
US

V. Phone/Fax

Practice location:
  • Phone: 480-846-0607
  • Fax:
Mailing address:
  • Phone: 602-330-9435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number286731
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: