Healthcare Provider Details

I. General information

NPI: 1275561821
Provider Name (Legal Business Name): VASCULAR IMAGING OF ARIZONA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 N. CENTRAL AVENUE SUITE 610
PHOENIX AZ
85012-2819
US

IV. Provider business mailing address

3033 N. CENTRAL AVENUE SUITE 610
PHOENIX AZ
85012-2819
US

V. Phone/Fax

Practice location:
  • Phone: 602-241-9971
  • Fax: 602-277-3910
Mailing address:
  • Phone: 602-241-9971
  • Fax: 602-277-3910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MS. ISMAR CINTORA
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: M.D.
Phone: 602-241-9971