Provider Demographics
NPI:1750822375
Name:ALEX J. ONOFREI, MD PC
Entity Type:Organization
Organization Name:ALEX J. ONOFREI, MD PC
Other - Org Name:AZ FAMILY MEDICINE AND SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ONOFREI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-807-3554
Mailing Address - Street 1:6130 E BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-4960
Mailing Address - Country:US
Mailing Address - Phone:480-807-3554
Mailing Address - Fax:480-807-8330
Practice Address - Street 1:6130 E BROWN RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4960
Practice Address - Country:US
Practice Address - Phone:480-807-3554
Practice Address - Fax:480-807-8330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9872261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care