Healthcare Provider Details

I. General information

NPI: 1235915513
Provider Name (Legal Business Name): LEILA DARBOUZE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 09/04/2023
Certification Date: 09/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 E ASCENT ST
TUCSON AZ
85719-0037
US

IV. Provider business mailing address

1109 E ASCENT ST
TUCSON AZ
85719-0037
US

V. Phone/Fax

Practice location:
  • Phone: 520-661-8768
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number281227
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: