Healthcare Provider Details

I. General information

NPI: 1386572444
Provider Name (Legal Business Name): REFOCUS MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6338 W PORT ROYALE LN
GLENDALE AZ
85306-3260
US

IV. Provider business mailing address

6338 W PORT ROYALE LN
GLENDALE AZ
85306-3260
US

V. Phone/Fax

Practice location:
  • Phone: 623-302-6460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CAMELIA MARTIN
Title or Position: OWNER
Credential: DNP, FNP-BC
Phone: 623-302-6460