Healthcare Provider Details

I. General information

NPI: 1780300574
Provider Name (Legal Business Name): VITO TONAZZI FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 W UNION HILLS DR
GLENDALE AZ
85308-2404
US

IV. Provider business mailing address

3650 W UNION HILLS DR
GLENDALE AZ
85308-2404
US

V. Phone/Fax

Practice location:
  • Phone: 623-451-5698
  • Fax:
Mailing address:
  • Phone: 623-451-5698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number282261
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: