Provider Demographics
NPI:1063664449
Name:ARVIZU, MIREYA M (RD)
Entity Type:Individual
Prefix:MRS
First Name:MIREYA
Middle Name:M
Last Name:ARVIZU
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 N WYATT DR STE 260
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6118
Mailing Address - Country:US
Mailing Address - Phone:520-795-0608
Mailing Address - Fax:520-323-4350
Practice Address - Street 1:2424 N WYATT DR STE 260
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6118
Practice Address - Country:US
Practice Address - Phone:520-392-7500
Practice Address - Fax:520-323-4350
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ927227133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered