Provider Demographics
NPI:1821067117
Name:NARVAIZ, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:NARVAIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 E STEAMBOAT BEND DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2177
Mailing Address - Country:US
Mailing Address - Phone:480-557-7982
Mailing Address - Fax:480-894-8881
Practice Address - Street 1:1050 E SOUTHERN AVE
Practice Address - Street 2:#A1
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5403
Practice Address - Country:US
Practice Address - Phone:480-557-7982
Practice Address - Fax:480-894-8881
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ240472084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG38849Medicare UPIN