Healthcare Provider Details

I. General information

NPI: 1962147694
Provider Name (Legal Business Name): NEW HORIZON MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 W PEORIA AVE STE D805
PHOENIX AZ
85029-4600
US

IV. Provider business mailing address

3201 W PEORIA AVE STE D805
PHOENIX AZ
85029-4600
US

V. Phone/Fax

Practice location:
  • Phone: 602-569-5437
  • Fax: 855-583-3686
Mailing address:
  • Phone: 602-715-1185
  • Fax: 855-583-3686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MIRTA DALOTTO
Title or Position: CEO
Credential:
Phone: 480-200-2296