Healthcare Provider Details

I. General information

NPI: 1033846936
Provider Name (Legal Business Name): JOSE ALBERTO URENA RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6017 S MORRIS BLVD
TUCSON AZ
85706-4217
US

IV. Provider business mailing address

6017 S MORRIS BLVD
TUCSON AZ
85706-4217
US

V. Phone/Fax

Practice location:
  • Phone: 520-954-9092
  • Fax:
Mailing address:
  • Phone: 520-954-9092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number022578
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: