Provider Demographics
NPI:1730126756
Name:AVILEZ, MARIA E (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:AVILEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9520 W PALM LN
Mailing Address - Street 2:#200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-4403
Mailing Address - Country:US
Mailing Address - Phone:623-583-3001
Mailing Address - Fax:623-583-3007
Practice Address - Street 1:7725 N 43RD AVE
Practice Address - Street 2:#510
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-5770
Practice Address - Country:US
Practice Address - Phone:877-809-5092
Practice Address - Fax:623-583-3007
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2016-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ28719207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ532871Medicaid
H30312Medicare UPIN
AZZ133921Medicare PIN