Healthcare Provider Details

I. General information

NPI: 1164682472
Provider Name (Legal Business Name): ENVITA MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 05/25/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8759 E BELL RD BLDG G
SCOTTSDALE AZ
85260-1322
US

IV. Provider business mailing address

9343 E BAHIA DR
SCOTTSDALE AZ
85260-1559
US

V. Phone/Fax

Practice location:
  • Phone: 602-569-4144
  • Fax:
Mailing address:
  • Phone: 602-569-4144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LACEY E ROBLES
Title or Position: ACCOUNTING MANAGER
Credential:
Phone: 480-569-2959