Provider Demographics
NPI:1720470669
Name:FABIO ALMEIDA MD, PLLC
Entity Type:Organization
Organization Name:FABIO ALMEIDA MD, PLLC
Other - Org Name:PHOENIX MOLECULAR IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FABIO
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALMEIDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-661-5125
Mailing Address - Street 1:PO BOX 205649
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-5649
Mailing Address - Country:US
Mailing Address - Phone:602-331-1771
Mailing Address - Fax:602-331-1773
Practice Address - Street 1:4540 E COTTON GIN LOOP
Practice Address - Street 2:SUITE 150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-4820
Practice Address - Country:US
Practice Address - Phone:602-331-1771
Practice Address - Fax:602-331-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33786207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Single Specialty