Healthcare Provider Details

I. General information

NPI: 1093437246
Provider Name (Legal Business Name): AZ ORTHOPEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10290 N 92ND ST STE 101
SCOTTSDALE AZ
85258-4508
US

IV. Provider business mailing address

PO BOX 33727
BELFAST ME
04915-0615
US

V. Phone/Fax

Practice location:
  • Phone: 480-697-4824
  • Fax: 480-697-4825
Mailing address:
  • Phone: 480-697-4824
  • Fax: 480-697-4825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ALICIA RASCHILLO
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 623-337-7597