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NPI Code Detail

MEDICARE: MATRIX MEDICAL NETWORK OF NORTH CAROLINA PC

MEDICARE: MATRIX MEDICAL NETWORK OF NORTH CAROLINA 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
1363L00000XNurse Practitioner

General Provider Information

NPI Number : 1790044899
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATRIX MEDICAL NETWORK OF NORTH CAROLINA PC
Provider Business Mailing Address
First Line : 9201 E MOUNTAIN VIEW RD
Second Line : SUITE 220
City : SCOTTSDALE
State : AZ
Zip : 85258-5199
Country : US
Telephone Number : 480-862-1700
Fax Number : 877-506-4560
Provider Business Practice Location Address
First Line : 301 MCCULLOUGH DR STE 400
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-1336
Country : US
Telephone Number : 480-862-1677
Fax Number : 480-718-7643
Authorized Official
Title or Position : DIRECTOR, CREDENTIALING
Name : VICTORIA ALVAREZ
Credential :
Telephone Number : 480-862-1695
Provider Enumeration Date : 05/09/2012
Last Update Date : 12/10/2019

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Directions to “MATRIX MEDICAL NETWORK OF NORTH CAROLINA PC ” Practice Location

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