MEDICARE: UNIVERSITY OF ARIZONA

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1992342281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF ARIZONA

Provider Business Mailing Address
First Line	:	4210 N CAMPBELL AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1109
Country	:	US
Telephone Number	:	404-333-3737
Fax Number	:

Provider Business Practice Location Address
First Line	:	4210 N CAMPBELL AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1109
Country	:	US
Telephone Number	:	520-621-1584
Fax Number	:

Authorized Official
Title or Position	:	EXTENSION SPECIALIST
Name	:	VANESSA R INFANTE
Credential	:	PHD, RD
Telephone Number	:	520-621-1584

Provider Enumeration Date	:	12/05/2019
Last Update Date	:	07/06/2021

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Directions to “UNIVERSITY OF ARIZONA ” Practice Location

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