Healthcare Provider Details

I. General information

NPI: 1821067117
Provider Name (Legal Business Name): ROBERTO NARVAIZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E SOUTHERN AVE #A1
TEMPE AZ
85282-5403
US

IV. Provider business mailing address

1417 E STEAMBOAT BEND DR
TEMPE AZ
85283-2177
US

V. Phone/Fax

Practice location:
  • Phone: 480-557-7982
  • Fax: 480-894-8881
Mailing address:
  • Phone: 480-557-7982
  • Fax: 480-894-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAZ24047
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberAZ24047
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: