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Organization

FOUR SEASONS MEDICAL SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GREGORY BRIAN MAXON MALDONADO (MANAGER/PRESIDENT)
(602) 369-8112
Entity
Organization

Contact information

Practice address
19820 N 7TH AVE, SUITE 230-D, PHOENIX, AZ 85027-4736
(602) 369-8112
Mailing address
2711 CENTERVILLE RD, SUITE 400, WILMINGTON, DE 19808-1660
(602) 369-8112

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
02/19/2016
Last updated
02/19/2016
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  • EDI platform