Provider Demographics
NPI:1619739323
Name:INNOVISTA TECH SOLUTIONS LLC
Entity type:Organization
Organization Name:INNOVISTA TECH SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELRAZIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-491-5489
Mailing Address - Street 1:6922 W ST CHARLES AVE
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-6963
Mailing Address - Country:US
Mailing Address - Phone:602-491-5489
Mailing Address - Fax:623-246-7060
Practice Address - Street 1:6922 W ST CHARLES AVE
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-5046
Practice Address - Country:US
Practice Address - Phone:602-491-5489
Practice Address - Fax:623-246-7060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationGroup - Multi-Specialty