Healthcare Provider Details

I. General information

NPI: 1346897899
Provider Name (Legal Business Name): MARINA LISA NORZAGARAY RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 S 6TH AVE
TUCSON AZ
85723-0001
US

IV. Provider business mailing address

6209 E 31ST ST
TUCSON AZ
85711-6824
US

V. Phone/Fax

Practice location:
  • Phone: 520-729-1450
  • Fax:
Mailing address:
  • Phone: 520-390-2538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number010649
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: