MEDICARE: SOUTHWEST HEART AND VASCULAR CARE, LTD.

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	207RC0000X	Cardiovascular Disease Physician	36740	AZ

General Provider Information

NPI Number	:	1902071590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST HEART AND VASCULAR CARE, LTD.

Provider Business Mailing Address
First Line	:	789 W 27TH ST STE 1
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7207
Country	:	US
Telephone Number	:	928-344-8400
Fax Number	:	928-344-8412

Provider Business Practice Location Address
First Line	:	789 W 27TH ST STE 1
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7207
Country	:	US
Telephone Number	:	928-344-8400
Fax Number	:	928-344-8412

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NOEL VILLANUEVA GUTIERREZ
Credential	:	M.D.
Telephone Number	:	928-344-8400

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	04/24/2008

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Directions to “SOUTHWEST HEART AND VASCULAR CARE, LTD. ” Practice Location

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