Provider Demographics
NPI:1972286003
Name:SUVIDA HEALTHCARE CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:SUVIDA HEALTHCARE CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-478-8432
Mailing Address - Street 1:211 E 7TH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3218
Mailing Address - Country:US
Mailing Address - Phone:888-478-8432
Mailing Address - Fax:
Practice Address - Street 1:225 E VALENCIA RD STE 135
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706-6866
Practice Address - Country:US
Practice Address - Phone:520-613-2967
Practice Address - Fax:520-314-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty