Provider Demographics
NPI:1861681454
Name:MARIA CRISTINA OSPINA MD PLC
Entity Type:Organization
Organization Name:MARIA CRISTINA OSPINA MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CRISTINA
Authorized Official - Last Name:OSPINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-277-2228
Mailing Address - Street 1:7500 N DREAMY DRAW DR
Mailing Address - Street 2:SUITE 133
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4660
Mailing Address - Country:US
Mailing Address - Phone:602-277-2228
Mailing Address - Fax:602-265-9494
Practice Address - Street 1:7500 N DREAMY DRAW DR
Practice Address - Street 2:SUITE 133
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4660
Practice Address - Country:US
Practice Address - Phone:602-277-2228
Practice Address - Fax:602-265-9494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37281261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z118242Medicare PIN
AZI13714Medicare UPIN
AZZ118242Medicare PIN