Provider Demographics
NPI:1447336821
Name:INFINITE HEALING SOLUTIONS PLLC
Entity type:Organization
Organization Name:INFINITE HEALING SOLUTIONS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-985-7070
Mailing Address - Street 1:6638 E BASELINE RD SUITE 103
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3741
Mailing Address - Country:US
Mailing Address - Phone:480-985-7070
Mailing Address - Fax:480-641-7408
Practice Address - Street 1:1234 S POWER RD STE 151
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3741
Practice Address - Country:US
Practice Address - Phone:480-985-7070
Practice Address - Fax:480-641-7408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6056111N00000X
AZ7427111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Not Answered111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU90888Medicare UPIN
AZU99367Medicare UPIN
AZ101759Medicare ID - Type UnspecifiedGROUP NUMBER