Healthcare Provider Details

I. General information

NPI: 1053391862
Provider Name (Legal Business Name): MARIA P ALZONA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 S 56TH ST STE 120
PHOENIX AZ
85034-2177
US

IV. Provider business mailing address

PO BOX 42210
PHOENIX AZ
85080-2210
US

V. Phone/Fax

Practice location:
  • Phone: 602-685-5211
  • Fax: 602-685-5325
Mailing address:
  • Phone: 623-889-7403
  • Fax: 623-889-7407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number33065
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number33065
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: