MEDICARE: DR. MONICA ELIZABETH VITERI-GIORDANO D.O.

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	207R00000X	Internal Medicine Physician	R1684	AZ
2	208000000X	Pediatrics Physician	R1684	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	R 1684	OTHER	AZ	ARIZONA OSTEOPATHIC TRAINING PERMIT NUMBER/ LICENSE NUMBER

General Provider Information

NPI Number	:	1063491041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONICA ELIZABETH VITERI-GIORDANO D.O.

Provider Business Mailing Address
First Line	:	37100 N. GANTZEL ROAD STE #201
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140
Country	:	US
Telephone Number	:	480-394-4469
Fax Number	:	480-394-4527

Provider Business Practice Location Address
First Line	:	1300 N 12TH ST STE 508
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2849
Country	:	US
Telephone Number	:	602-839-4777
Fax Number	:	602-839-4233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	12/13/2013

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