Healthcare Provider Details

I. General information

NPI: 1144365420
Provider Name (Legal Business Name): ROBERT P LUBERTO DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 12/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7717 W DEER VALLEY RD
PEORIA AZ
85382-2102
US

IV. Provider business mailing address

7717 W DEER VALLEY RD
PEORIA AZ
85382-2102
US

V. Phone/Fax

Practice location:
  • Phone: 623-561-6300
  • Fax: 623-572-5400
Mailing address:
  • Phone: 623-561-6300
  • Fax: 623-572-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT PHILIP LUBERTO
Title or Position: OWNER
Credential: D.O.
Phone: 623-561-6300