ENROUTE PROVIDER SERVICES LLC
NPI 1285485920
General Practice in Glendale, AZ

Active since April 01, 2024
17505 N 79TH AVE STE 313A, GLENDALE, AZ 85308(623) 225-5875 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 20, 2024, Apr 2, 2024 (2 updates tracked since 2024).

About Enroute Provider Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ENROUTE PROVIDER SERVICES LLC (NPI 1285485920) is a healthcare organization registered as a general practice in Glendale, Arizona and active in the NPI registry since April 2024. The organization lists Dunedin Hervias, Founder, as its authorized official.

NPPES Registry Identity

NPI1285485920
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameENROUTE PROVIDER SERVICES LLC
Location Address17505 N 79TH AVE STE 313AGlendale, AZ 85308-8730
Mailing Address17505 N 79th Ave Ste 313aGlendale, AZ 85308-8730 · (623) 225-5875
Organization SubpartNo
Authorized OfficialDunedin HerviasFounder · (623) 225-5875
Enumeration DateApril 1, 2024
Last NPPES UpdateJune 20, 20242 updates tracked since enumeration
NPPES CertifiedJune 20, 2024
NPI 1285485920 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedNurse PractitionerTaxonomy 363L00000X
17505 N 79TH AVE STE 313A, Glendale, AZ 85308

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285485920, enumerated as an "organization" on April 01, 2024.

The provider is located at 17505 N 79TH AVE STE 313A GLENDALE, AZ 85308 and the phone number is (623) 225-5875.

General Practice with taxonomy code 208D00000X.