Healthcare Provider Details

I. General information

NPI: 1710958616
Provider Name (Legal Business Name): MARIA SIFONTES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9348 E RITA RD SUITE 100
TUCSON AZ
85747-6312
US

IV. Provider business mailing address

PO BOX 31235
TUCSON AZ
85751-1235
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-4760
  • Fax: 520-324-4759
Mailing address:
  • Phone: 520-324-2308
  • Fax: 520-324-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24214
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: