Healthcare Provider Details

I. General information

NPI: 1639374630
Provider Name (Legal Business Name): CLARIMAR BORRERO-MEJIAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLARIMAR BORRERO M.D.

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E THOMAS RD
PHOENIX AZ
85016-7710
US

IV. Provider business mailing address

3200 E CAMELBACK RD STE 250
PHOENIX AZ
85018-2327
US

V. Phone/Fax

Practice location:
  • Phone: 602-933-0970
  • Fax: 602-933-4253
Mailing address:
  • Phone: 602-933-1813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11478
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberR72012
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number47429
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: