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General NPI Number Information
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NPI Number | 1023197548
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Entity Type | Individual
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Provider Name | FREDERICO LEAO GITIRANA D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15090 N NORTHSIGHT BLVD 104
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2610
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Country | US
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Telephone | 480-368-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 15206 E MUSTANG DR
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-4846
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Country | US
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Telephone | 480-255-0252
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7251
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License Number State | AZ
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