MEDICARE: AXIS PHOENIX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1043173917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AXIS PHOENIX LLC

Provider Business Mailing Address
First Line	:	4515 N 16TH ST STE 106
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-5362
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4515 N 16TH ST STE 106
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-5362
Country	:	US
Telephone Number	:	702-277-0578
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT HERNANDEZ
Credential	:	DC
Telephone Number	:	702-277-0578

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “AXIS PHOENIX LLC ” Practice Location

Language	Start Address	Practice Location

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