Healthcare Provider Details

I. General information

NPI: 1962436691
Provider Name (Legal Business Name): METRO HEART CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 N 7TH STREET SUITE 375
PHOENIX AZ
85006
US

IV. Provider business mailing address

1331 N 7TH STREET SUITE 375
PHOENIX AZ
85006
US

V. Phone/Fax

Practice location:
  • Phone: 602-307-0070
  • Fax: 602-307-0080
Mailing address:
  • Phone: 602-307-0070
  • Fax: 602-307-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ROBERT KRALIK
Title or Position: CEO PRESIDEN
Credential: MD
Phone: 602-307-0070