Healthcare Provider Details

I. General information

NPI: 1902683238
Provider Name (Legal Business Name): PROSANO HEALTH SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 S VAL VISTA DR STE B105
GILBERT AZ
85297-7319
US

IV. Provider business mailing address

8220 N 23RD AVE
PHOENIX AZ
85021-4872
US

V. Phone/Fax

Practice location:
  • Phone: 855-776-7266
  • Fax:
Mailing address:
  • Phone: 855-776-7266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number StateNULL

VIII. Authorized Official

Name: AARON BOWEN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 480-493-7249