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General NPI Number Information
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NPI Number | 1750903068
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Entity Type | Organization
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Legal Business Name | MATRIX MEDICAL NETWORK OF NEBRASKA PC
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 233 S 13TH ST STE 1900
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City | LINCOLN
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State | NE
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Zip | 68508-2000
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Country | US
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Telephone | 480-862-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 9201 E MOUNTAIN VIEW RD STE 220
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5172
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Country | US
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Telephone | 480-862-1677
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, CREDENTIALING
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Name | VICTORIA ALVAREZ
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Credential |
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Telephone | 480-862-1695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease 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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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