Provider Demographics
NPI:1386810216
Name:FIT HEALTH CARE LLC
Entity type:Organization
Organization Name:FIT HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMERDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:602-279-5049
Mailing Address - Street 1:300 W CLARENDON AVE
Mailing Address - Street 2:STE 145
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3420
Mailing Address - Country:US
Mailing Address - Phone:602-279-5049
Mailing Address - Fax:602-279-5720
Practice Address - Street 1:300 W CLARENDON AVE
Practice Address - Street 2:STE 145
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3420
Practice Address - Country:US
Practice Address - Phone:602-279-5049
Practice Address - Fax:602-279-5720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ568766Medicaid
AZ505945Medicaid
AZ568766Medicaid