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NPI Code Detail

MEDICARE: TARA MAE SPATARO ST

MEDICARE:   TARA MAE SPATARO  ST
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
1246ZS0410XSurgical Technologist

General Provider Information

NPI Number : 1114471331
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA MAE SPATARO ST
Provider Business Mailing Address
First Line : 8390 E VIA DE VENTURA
Second Line : SUITE F110
City : SCOTTSDALE
State : AZ
Zip : 85258-3188
Country : US
Telephone Number : 602-740-5302
Fax Number :
Provider Business Practice Location Address
First Line : 8390 E VIA DE VENTURA
Second Line : SUITE F110
City : SCOTTSDALE
State : AZ
Zip : 85258-3188
Country : US
Telephone Number : 602-740-5302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2016
Last Update Date : 08/04/2016

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Directions to “ TARA MAE SPATARO ST” Practice Location

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