Healthcare Provider Details

I. General information

NPI: 1922619410
Provider Name (Legal Business Name): SCOTTSDALE VEIN AND CARDIOLOGY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8752 E VIA DE COMMERCIO STE 2
SCOTTSDALE AZ
85258-3396
US

IV. Provider business mailing address

8752 E VIA DE COMMERCIO STE 2
SCOTTSDALE AZ
85258-3396
US

V. Phone/Fax

Practice location:
  • Phone: 480-465-0242
  • Fax:
Mailing address:
  • Phone: 480-465-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEBORAH LYNN FINNEY
Title or Position: OWNER
Credential:
Phone: 602-628-6634