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NPI Code Detail

MEDICARE: ARIZONA UROLOGY SPECIALISTS, PLLC

MEDICARE: ARIZONA UROLOGY SPECIALISTS, PLLC
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
1332900000XNon-Pharmacy Dispensing Site

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720449689
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA UROLOGY SPECIALISTS, PLLC
Provider Business Mailing Address
First Line : 77 E THOMAS RD STE 230
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-3100
Country : US
Telephone Number : 602-557-0007
Fax Number : 602-557-0001
Provider Business Practice Location Address
First Line : 1313 E OSBORN RD STE 150
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-5688
Country : US
Telephone Number : 602-264-4431
Fax Number : 602-266-3870
Authorized Official
Title or Position : PRESIDENT
Name : CESAR GILBERTO BRITO
Credential : MD
Telephone Number : 480-661-2662
Provider Enumeration Date : 03/18/2016
Last Update Date : 04/09/2019

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