Movement Disorders Center Of Arizona LLC
Psychiatry & Neurology, Neurology in Surprise, AZ. Organization (NPI-2).
NPI number1295050409
StatusActive
Last updated in NPPESMay 2, 2012
Details
- NPI
- 1295050409
- Entity type
- Organization (NPI-2)
- Legal business name
- Movement Disorders Center Of Arizona LLC
- Organization subpart
- No
- Enumeration date
- Mar 30, 2010
- Last updated
- May 2, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | – | – | Yes |
Practice location
13945 W Grand AveSuite 102
Surprise, AZ 85374-2437
Phone 480-526-5441 · Fax 480-526-5443
Mailing address
10635 N 140th WayScottsdale, AZ 85259-5500
Phone 480-526-5449 · Fax 480-526-5443
Authorized official
Virgilio Gerald Hilario Evidente
Sole Member
4805265449
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