Provider Demographics
NPI:1356624258
Name:ARIZONA HEART CENTER, LLC
Entity type:Organization
Organization Name:ARIZONA HEART CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAREK
Authorized Official - Middle Name:ZBIGNIEW
Authorized Official - Last Name:PIATEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-509-5169
Mailing Address - Street 1:4338 W THOMAS RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-3878
Mailing Address - Country:US
Mailing Address - Phone:623-385-7925
Mailing Address - Fax:877-903-8614
Practice Address - Street 1:4338 W THOMAS RD
Practice Address - Street 2:SUITE 116
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-3878
Practice Address - Country:US
Practice Address - Phone:623-385-7925
Practice Address - Fax:877-903-8614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41175207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty