Healthcare Provider Details

I. General information

NPI: 1992340053
Provider Name (Legal Business Name): CATARINO PEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5430 DISTINCTION WAY
PRESCOTT AZ
86301-8437
US

IV. Provider business mailing address

7301 N 16TH ST STE 102
PHOENIX AZ
85020-5266
US

V. Phone/Fax

Practice location:
  • Phone: 928-445-1919
  • Fax:
Mailing address:
  • Phone: 480-420-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number341829
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: