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General NPI Number Information
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NPI Number | 1326628512
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Entity Type | Organization
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Legal Business Name | PASSION HEALTH LLC
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 06/05/2021
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Provider Practice Location Address
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Address Line | 2550 W UNION HILLS DR STE 350
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City | PHOENIX
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State | AZ
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Zip | 85027-5187
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Country | US
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Telephone | 480-296-5429
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Fax | 480-900-8525
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Provider Business Mailing Address
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Address Line | 2550 W UNION HILLS DRIVE SUITE 350 OFFICE 317B
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City | PHOENIX
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State | AZ
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Zip | 85027-5187
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Country | US
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Telephone | 480-296-5429
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Fax | 480-900-8525
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. NICHOLAS XAVIER CICCIARELLI
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Credential |
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Telephone | 480-296-5429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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