MEDICARE: RUDY AREVALO

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	405300000X	Prevention Professional	1144762394	AZ

General Provider Information

NPI Number	:	1871436535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUDY AREVALO

Provider Business Mailing Address
First Line	:	5314 S CROWN JEWEL DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85706-3674
Country	:	US
Telephone Number	:	520-971-9987
Fax Number	:	520-393-3809

Provider Business Practice Location Address
First Line	:	5314 S CROWN JEWEL DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85706-3674
Country	:	US
Telephone Number	:	520-971-9987
Fax Number	:	520-393-3809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “ RUDY AREVALO ” Practice Location

Language	Start Address	Practice Location

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