Organization
GENERATIONS FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARLA SUE VITALE DO (OWNER)
(623) 537-5170
Entity
Organization
Contact information
Practice address
13945 W GRAND AVE, SUITE A-101, SURPRISE, AZ 85374-2437
(623) 537-5170
(623) 537-5274
Mailing address
13945 W GRAND AVE, SUITE A-101, SURPRISE, AZ 85374-2437
(623) 537-5170
(623) 537-5274
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
3874
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z1716
HEALTH NET
AZ
01
—
7039717
AETNA
AZ
05
—
954140
—
AZ
01
—
AZ0442900
BCBS
AZ
Enumeration date
06/20/2007
Last updated
08/18/2008
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