Provider Demographics
NPI:1861561011
Name:ROBLEDO, JOSE L (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:L
Last Name:ROBLEDO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15835 S 46TH ST
Mailing Address - Street 2:SUITE 132
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0446
Mailing Address - Country:US
Mailing Address - Phone:480-598-9733
Mailing Address - Fax:480-598-8891
Practice Address - Street 1:15835 S 46TH ST
Practice Address - Street 2:SUITE 132
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0446
Practice Address - Country:US
Practice Address - Phone:480-598-9733
Practice Address - Fax:480-598-8891
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2016-03-29
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Provider Licenses
StateLicense IDTaxonomies
AZ13386207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0036500OtherBCBS
AZ219908Medicaid
AZ86-0429186OtherTRICARE
AZE00231Medicare UPIN