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General NPI Number Information
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NPI Number | 1922806017
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Entity Type | Organization
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Legal Business Name | SUN VALLEY WOUND CARE LLC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 560 W BROWN ROAD SUITE 3001, 3RD FLOOR
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City | MESA
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State | AZ
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Zip | 85201-3221
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Country | US
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Telephone | 602-686-0059
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Fax | 480-686-8263
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Provider Business Mailing Address
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Address Line | 560 W BROWN ROAD SUITE 3001, 3RD FLOOR
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City | MESA
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State | AZ
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Zip | 85201-3221
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Country | US
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Telephone | 602-686-0059
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Fax | 480-686-8263
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Authorized Official
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Title or Position | MANAGER
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Name | BERTHA LUISA PINTO MORANTE
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Credential |
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Telephone | 602-686-0059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | NULL
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | NULL
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