Healthcare Provider Details

I. General information

NPI: 1669115515
Provider Name (Legal Business Name): ANASTAPLO AND REDLEAF CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9617 APACHE AVE NE STE 102
ALBUQUERQUE NM
87112-2907
US

IV. Provider business mailing address

9617 APACHE AVE NE STE 102
ALBUQUERQUE NM
87112-2907
US

V. Phone/Fax

Practice location:
  • Phone: 773-750-6555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MIRIAM I REDLEAF
Title or Position: OWNER
Credential:
Phone: 505-677-0890