Healthcare Provider Details

I. General information

NPI: 1831980986
Provider Name (Legal Business Name): MULBERRY MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 S MCCLINTOCK DR STE 104
TEMPE AZ
85283-6002
US

IV. Provider business mailing address

PO BOX 51270
MESA AZ
85208-0064
US

V. Phone/Fax

Practice location:
  • Phone: 623-220-2601
  • Fax: 623-220-2602
Mailing address:
  • Phone: 623-220-2601
  • Fax: 623-220-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH FURTADO
Title or Position: PRESIDENT/CEO
Credential: RN
Phone: 623-220-2601