Healthcare Provider Details

I. General information

NPI: 1588820484
Provider Name (Legal Business Name): ERNEST R. VINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N CAMPBELL AVE
TUCSON AZ
85724-5103
US

IV. Provider business mailing address

PO BOX 245093
TUCSON AZ
85724-5093
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax: 520-505-2476
Mailing address:
  • Phone: 520-626-2587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number49419
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD442172
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: