Healthcare Provider Details
I. General information
NPI: 1851233365
Provider Name (Legal Business Name): CITRUS PRIMARY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14040 N CAVE CREEK RD STE 210
PHOENIX AZ
85022-6179
US
IV. Provider business mailing address
14040 N CAVE CREEK RD STE 210
PHOENIX AZ
85022-6179
US
V. Phone/Fax
- Phone: 623-278-4141
- Fax:
- Phone: 623-278-4141
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEXANDRA
CAIENAR
Title or Position: CEO
Credential: NP
Phone: 623-276-6136