Healthcare Provider Details

I. General information

NPI: 1720449689
Provider Name (Legal Business Name): ARIZONA UROLOGY SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 E OSBORN RD STE 150
PHOENIX AZ
85014-5688
US

IV. Provider business mailing address

77 E THOMAS RD STE 230
PHOENIX AZ
85012-3100
US

V. Phone/Fax

Practice location:
  • Phone: 602-264-4431
  • Fax: 602-266-3870
Mailing address:
  • Phone: 602-557-0007
  • Fax: 602-557-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: CESAR GILBERTO BRITO
Title or Position: PRESIDENT
Credential: MD
Phone: 480-661-2662