Deidra Amico, CPT, CET

Individual provider Active NPI Phlebotomy Technician · Maricopa, AZ

NPI 1639855331 · NPPES record last updated Jun 30, 2023

Key facts

NPI
1639855331
Entity type
Individual (NPI type 1)
Primary specialty
Phlebotomy Technician 246RP1900X
License
R9H3P3P4 (NJ)
Practice address
45096 W Buckhorn TRL
Maricopa, AZ 85139-4171
Phone
(520) 431-2518
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R9H3P3P4NJMDPhlebotomy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Vibrations LLC Single Specialty Current
since Jul 2, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician
Group: 193400000X SINGLE SPECIALTY GROUP
246RP1900X R9H3P3P4 NJ Yes

Addresses

Primary practice location

45096 W Buckhorn TRL
Maricopa, AZ 85139-4171

Mailing address

45096 W Buckhorn TRL
Maricopa, AZ 85139-4171
Phone (520) 431-2518

Other providers in Maricopa, AZ

All providers in Maricopa, AZ · Phlebotomy Technician in Arizona

Sources for this page

Verify at the official NPI Registry.