MEDICARE: WELLCARE HEALTH INSURANCE OF ARIZONA, INC.

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	302R00000X	Health Maintenance Organization

General Provider Information

NPI Number	:	1952625204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.

Provider Business Mailing Address
First Line	:	8735 HENDERSON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-1143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8735 HENDERSON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-1143
Country	:	US
Telephone Number	:	813-290-6200
Fax Number	:

Authorized Official
Title or Position	:	VP & SECRETARY
Name	:	MICHAEL HABER
Credential	:
Telephone Number	:	813-206-1490

Provider Enumeration Date	:	03/16/2010
Last Update Date	:	05/05/2016

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