Healthcare Provider Details

I. General information

NPI: 1346003365
Provider Name (Legal Business Name): PIMA HEART PHYSICIANS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12115 N ORACLE RD STE 101
ORO VALLEY AZ
85737-7841
US

IV. Provider business mailing address

555 E RIVER RD STE 101
TUCSON AZ
85704-5843
US

V. Phone/Fax

Practice location:
  • Phone: 520-838-3540
  • Fax: 520-325-3526
Mailing address:
  • Phone: 520-838-3540
  • Fax: 520-325-3526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA MARCELLA RASNAKE
Title or Position: REGIONAL PRESIDENT
Credential:
Phone: 520-838-2411