VIDAL MEDICAL OFFICE PLC NPI 1023112760

NPI Information

VIDAL MEDICAL OFFICE PLC is an adult medicine family medicine in Maricopa, AZ. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. VIDAL MEDICAL OFFICE PLC NPI is 1023112760. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

21300 N JOHN WAYNE PKWY
UNIT 116 BLDG 7
MARICOPA, AZ
ZIP 85139-979
Phone: (520) 423-9699
Fax: (520) 423-9599

The provider's authorized official is Hilda Flores-vidal .
The authorized official title is Owner and has the following contact phone number (520) 423-9699.

The CLIA number assigned to this NPI record is 03D1067930 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/12/2006 and was last updated on 4/3/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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