Healthcare Provider Details

I. General information

NPI: 1750206215
Provider Name (Legal Business Name): SARAY MORA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 W BUTLER DR
PEORIA AZ
85345-8057
US

IV. Provider business mailing address

8540 W BUTLER DR
PEORIA AZ
85345-8057
US

V. Phone/Fax

Practice location:
  • Phone: 623-412-4703
  • Fax:
Mailing address:
  • Phone: 623-412-4703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number312350
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number312350
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: