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4150 N 108th Ave Ste 142 Phoenix AZ 85037-5467 | |
| (623) 242-9259 | |
| (623) 466-9552 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 4150 N 108th Ave Ste 142, Phoenix, Arizona |
| Authorized Official Name and Position | Gladymar Vrkic (COO) |
| Authorized Official Contact | 8136109031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4150 N 108th Ave Ste 142 Phoenix AZ 85037-5467 Ph: (623) 242-9259 | 4150 N 108th Ave Ste 142 Phoenix AZ 85037-5467 Ph: (623) 242-9259 |
| NPI Number | 1215702535 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 08/20/2024 |
| Medicare PECOS PAC ID | 3971041328 |
|---|---|
| Medicare Enrollment ID | O20240815003170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215702535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Antonio T Uvas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730109745 PECOS PAC ID: 4183690829 Enrollment ID: I20061016000144 |
| Provider Name | Katherine E Gross |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336584184 PECOS PAC ID: 7416254164 Enrollment ID: I20190904003030 |
| Provider Name | Stefany Sheree Irizarry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679174262 PECOS PAC ID: 2961896097 Enrollment ID: I20220306000016 |
| Provider Name | Silvia Yaneth Sanchez Cardenas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295299402 PECOS PAC ID: 6507210655 Enrollment ID: I20230925000274 |
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