Healthcare Provider Details

I. General information

NPI: 1982546248
Provider Name (Legal Business Name): RAUL BURGOS JIMENEZ RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7812 E SPEEDWAY BLVD
TUCSON AZ
85710-1649
US

IV. Provider business mailing address

7812 E SPEEDWAY BLVD
TUCSON AZ
85710-1649
US

V. Phone/Fax

Practice location:
  • Phone: 520-885-3540
  • Fax:
Mailing address:
  • Phone: 520-885-3540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS027905
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: