MEDICARE: LAS SENDAS CARDIOLOGY, PC

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		AZ
2	207RC0000X	Cardiovascular Disease Physician

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

General Provider Information

NPI Number	:	1316299118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS SENDAS CARDIOLOGY, PC

Provider Business Mailing Address
First Line	:	3514 N POWER RD STE 107
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85215-2907
Country	:	US
Telephone Number	:	480-361-9949
Fax Number	:	480-361-9969

Provider Business Practice Location Address
First Line	:	3514 N POWER RD
Second Line	:	SUITE 107
City	:	MESA
State	:	AZ
Zip	:	85215-2903
Country	:	US
Telephone Number	:	480-361-9949
Fax Number	:	480-361-9969

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	AFROZE ARA AHMAD
Credential	:	MD
Telephone Number	:	480-361-9949

Provider Enumeration Date	:	10/04/2012
Last Update Date	:	05/20/2013

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