Healthcare Provider Details

I. General information

NPI: 1437513595
Provider Name (Legal Business Name): ALEXANDRA RODRIGUEZ GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 10/27/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 155
PHOENIX AZ
85037-3360
US

IV. Provider business mailing address

9305 W THOMAS RD STE 155
PHOENIX AZ
85037-0910
US

V. Phone/Fax

Practice location:
  • Phone: 623-936-1780
  • Fax:
Mailing address:
  • Phone: 623-936-1780
  • Fax: 623-936-9116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number61794
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: