Healthcare Provider Details

I. General information

NPI: 1457703191
Provider Name (Legal Business Name): MATTHEW FIERRO O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15255 N HAYDEN RD
SCOTTSDALE AZ
85260-2551
US

IV. Provider business mailing address

15255 N HAYDEN RD
SCOTTSDALE AZ
85260-2551
US

V. Phone/Fax

Practice location:
  • Phone: 480-609-0363
  • Fax: 602-794-6777
Mailing address:
  • Phone: 480-609-0363
  • Fax: 602-794-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2134
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: