Healthcare Provider Details

I. General information

NPI: 1316390883
Provider Name (Legal Business Name): RAFAEL T URCIS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 W MEEKER BLVD
SUN CITY WEST AZ
85375-5282
US

IV. Provider business mailing address

2525 W BERYL AVE
PHOENIX AZ
85021-1606
US

V. Phone/Fax

Practice location:
  • Phone: 623-524-4000
  • Fax:
Mailing address:
  • Phone: 602-424-7967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number45062
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RAFAEL THOMAS URCIS
Title or Position: OWNER/
Credential: MD
Phone: 714-618-5194