Healthcare Provider Details

I. General information

NPI: 1487215919
Provider Name (Legal Business Name): ALESSANDRO CAROTENUTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 E MCDOWELL RD
PHOENIX AZ
85006-2606
US

IV. Provider business mailing address

1010 E MCDOWELL RD STE 206
PHOENIX AZ
85006-2608
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-1250
  • Fax:
Mailing address:
  • Phone: 602-956-1250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number73731
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: