Individual
FEDELIA MAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1473 N DYSART RD, SUITE 100, AVONDALE, AZ 85323-1548
(623) 925-4931
(623) 882-0839
Mailing address
11001 N BLACK CANYON HWY, PHOENIX, AZ 85029-4757
(602) 942-4462
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3440
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194907
—
AZ
Enumeration date
03/05/2007
Last updated
07/22/2008
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