Healthcare Provider Details

I. General information

NPI: 1922823897
Provider Name (Legal Business Name): SANDRA ROCA GARAVITO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8020 N CORTARO RD STE 150
TUCSON AZ
85743-8315
US

IV. Provider business mailing address

8020 N CORTARO RD STE 150
TUCSON AZ
85743-8315
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax: 520-399-8575
Mailing address:
  • Phone: 520-694-8888
  • Fax: 520-399-8575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1156698
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11032095
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number307857
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: