Healthcare Provider Details

I. General information

NPI: 1821625484
Provider Name (Legal Business Name): TAWANY CHRISOSTOMO DA ROLD ALMEIDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11209 N TATUM BLVD STE 255
PHOENIX AZ
85028-6025
US

IV. Provider business mailing address

11209 N TATUM BLVD STE 255
PHOENIX AZ
85028-6061
US

V. Phone/Fax

Practice location:
  • Phone: 602-494-5050
  • Fax:
Mailing address:
  • Phone: 602-494-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number80275
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0116033830
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: