MEDICARE: FELIZ FAMILY CARE, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	207Y00000X	Otolaryngology Physician
3	363A00000X	Physician Assistant
4	208D00000X	General Practice Physician
5	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1538533799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELIZ FAMILY CARE, PLLC

Provider Business Mailing Address
First Line	:	1345 E MAIN ST STE 205
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-8961
Country	:	US
Telephone Number	:	480-264-3711
Fax Number	:	480-272-7580

Provider Business Practice Location Address
First Line	:	1345 E MAIN ST STE 100
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-8950
Country	:	US
Telephone Number	:	480-264-3711
Fax Number	:	480-272-7580

Authorized Official
Title or Position	:	CEO
Name	:	ROMAN CARRASCO
Credential	:
Telephone Number	:	480-404-7158

Provider Enumeration Date	:	11/25/2015
Last Update Date	:	12/10/2025

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