Provider Demographics
NPI:1417021486
Name:MATEUS, BEATRIZ A (MD)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:A
Last Name:MATEUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 N CENTRAL AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2904
Mailing Address - Country:US
Mailing Address - Phone:602-952-3400
Mailing Address - Fax:602-952-3401
Practice Address - Street 1:3003 N CENTRAL AVE STE 305
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2904
Practice Address - Country:US
Practice Address - Phone:602-952-3400
Practice Address - Fax:602-952-3401
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ338022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ963472Medicaid
AZ141913Medicare UPIN
AZ141913Medicare UPIN