Healthcare Provider Details

I. General information

NPI: 1598645020
Provider Name (Legal Business Name): MAX CESARIO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E UNIVERSITY BLVD
TUCSON AZ
85721-0001
US

IV. Provider business mailing address

3300 N SCOTTSDALE RD APT 4060
SCOTTSDALE AZ
85251-6581
US

V. Phone/Fax

Practice location:
  • Phone: 520-621-2211
  • Fax:
Mailing address:
  • Phone: 815-557-7567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number290480
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: