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
Phone: (520) 364-1429
Fax: (520) 364-4261
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720042385 | NPPES |
| Arizona | MEDICAID | 502527 |
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