Moreno, Mario

Moreno, Mario is an individual health care provider with primary practice located at 1100 F Ave , Douglas AZ 85607-1919. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Moreno, Mario can be contacted via phone (520) 364-1429.

Contact Information

Primary practice address
1100 F Ave Douglas AZ 85607-1919
Fax: (520) 364-4261
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0505526 Arizona

Profile Details

NPI number 1720042385
LBN Legal business name Moreno, Mario
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2006
Last updated Jun 12th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720042385 NPPES
Arizona MEDICAID 502527

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