Organization · NPI-2

5233 Medical Group, LLC

Physical Medicine & Rehabilitation · Mesa, AZ

NPI number1801368360
StatusActive
Last updated in NPPESDec 21, 2018

Details

NPI
1801368360
Entity type
Organization (NPI-2)
Legal business name
5233 Medical Group, LLC
Organization subpart
No
Enumeration date
Dec 21, 2018
Last updated
Dec 21, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation––Yes

Practice location

5233 E Southern Ave Ste 103
Mesa, AZ 85206-3628

Phone 480-830-2882 · Fax 480-830-2881

Mailing address

5233 E Southern Ave Ste 103
Mesa, AZ 85206-3628

Phone 480-830-2882

Authorized official

Derek Paul Pruni
Member
4808302882

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