Healthcare Provider Details

I. General information

NPI: 1699025981
Provider Name (Legal Business Name): MARIA GONZALEZ BERLARI, MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 W INDIAN SCHOOL ROAD, BUILDING 5 SUITE 118
PHOENIX AZ
85037
US

IV. Provider business mailing address

202 E EARLL DR STE 360
PHOENIX AZ
85012-2677
US

V. Phone/Fax

Practice location:
  • Phone: 623-247-5700
  • Fax: 623-849-0717
Mailing address:
  • Phone: 480-788-5621
  • Fax: 480-779-1277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number41464
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIUP A KIM
Title or Position: MD
Credential: MD
Phone: 480-323-6072