Mira Vita Metamophosis, LLC
NPI 1073910873 · Internal Medicine Physician · Glendale, AZ
Mira Vita Metamophosis, LLC is a Internal Medicine Physician organization in Glendale, AZ (NPI 1073910873).
Provider details
- NPI number
- 1073910873
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Angela Derosa, Owner(480) 619-4097
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-11-24
- Last updated
- 2020-01-30
- Certified
- 2020-01-30
Frequently asked questions
- What is Mira Vita Metamophosis, LLC's NPI number?
- Mira Vita Metamophosis, LLC's National Provider Identifier (NPI) is 1073910873, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mira Vita Metamophosis, LLC?
- Mira Vita Metamophosis, LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Mira Vita Metamophosis, LLC located?
- Mira Vita Metamophosis, LLC's practice location on file with NPPES is 5620 W Thunderbird Rd Ste H2, Glendale, AZ 85306-4653.
- What is Mira Vita Metamophosis, LLC's phone number?
- The practice phone number listed in the NPPES registry for Mira Vita Metamophosis, LLC is (480) 407-9007.
- Who is the authorized official for Mira Vita Metamophosis, LLC?
- The authorized official listed on Mira Vita Metamophosis, LLC's NPPES record is Angela Derosa, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mira Vita Metamophosis, LLC's NPI active?
- Yes — Mira Vita Metamophosis, LLC's NPI (1073910873) is active in the NPPES registry as of the last update on 2020-01-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.