Healthcare Provider Details

I. General information

NPI: 1013151604
Provider Name (Legal Business Name): APEX HEART CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 W CACTUS RD
PHOENIX AZ
85029-2238
US

IV. Provider business mailing address

8259 N 1ST DR
PHOENIX AZ
85021-5569
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-2141
  • Fax: 602-956-2725
Mailing address:
  • Phone: 602-300-2793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MYRON B LICHT
Title or Position: OWNER
Credential: DO
Phone: 602-300-2793