OrganizationActive
Heavenly Soles PLLC
NPI 1114342169 · Primary Podiatric Medicine Podiatrist · Surprise, AZ
Provider details
- NPI number
- 1114342169
- Entity type
- Organization
- Primary specialty
- Primary Podiatric Medicine PodiatristPodiatric Medicine & Surgery Service Providers
- Organization subpart
- No
- Authorized official
- Marie Paul, Manager(623) 584-0760
- License
- 0711 (AZ)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Ambulatory Health Care Facilities
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Practice location
13954 W Waddell Rd
Suite 307
Surprise, AZ 85379-8750
Phone: (623) 584-0760
Fax: (623) 546-0344
Approximate (ZIP-level) locationGet directions
Mailing address
13954 W Waddell Rd
Surprise, AZ 85379-8750
Registry dates
- Enumerated
- 2014-02-27
- Last updated
- 2016-11-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.