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General NPI Number Information
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NPI Number | 1114817731
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Entity Type | Individual
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Provider Name | GIOVANNY CASADIEGO CUBIDES MD, MSC, FRCPSC
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Gender | Male
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 1919 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85016-7710
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Country | US
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Telephone | 662-993-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 6545 E 4TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-5107
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Country | US
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Telephone |
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | PENDING
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License Number State | AZ
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