Organization
ENROUTE PROVIDER SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUNEDIN HERVIAS MBA, MHA, LSSBB (FOUNDER)
(623) 225-5875
Entity
Organization
Contact information
Practice address
17505 N 79TH AVE STE 313A, GLENDALE, AZ 85308-8730
(623) 225-5875
Mailing address
17505 N 79TH AVE STE 313A, GLENDALE, AZ 85308-8730
(623) 225-5875
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/01/2024
Last updated
06/20/2024
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