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General NPI Number Information
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NPI Number | 1831980986
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Entity Type | Organization
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Legal Business Name | MULBERRY MEDICAL LLC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 5801 S MCCLINTOCK DR STE 104
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City | TEMPE
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State | AZ
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Zip | 85283-6002
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Country | US
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Telephone | 623-220-2601
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Fax | 623-220-2602
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Provider Business Mailing Address
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Address Line | PO BOX 51270
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City | MESA
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State | AZ
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Zip | 85208-0064
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Country | US
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Telephone | 623-220-2601
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Fax | 623-220-2602
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. JOSEPH FURTADO
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Credential | RN
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Telephone | 623-220-2601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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