1285195669 NPI number — DR. ANYUL MELISSA FEREZ-PINZON MD

Table of content: DR. ANYUL MELISSA FEREZ-PINZON MD (NPI 1285195669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285195669 NPI number — DR. ANYUL MELISSA FEREZ-PINZON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FEREZ-PINZON
Provider First Name:
ANYUL
Provider Middle Name:
MELISSA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285195669
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4700 WATERS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAVANNAH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31404-6220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-350-8598
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6130 N LA CHOLLA BLVD STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85741-3574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-797-6881
Provider Business Practice Location Address Fax Number:
520-219-4926
Provider Enumeration Date:
03/27/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 73249 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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