| Brain Power Medical Center Llc | |
|
3430 E Flamingo Rd Ste 104 Las Vegas NV 89121-5070 | |
| (510) 456-8143 | |
| Not Available |
| Full Name | Brain Power Medical Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 3430 E Flamingo Rd Ste 104, Las Vegas, Nevada |
| Authorized Official Name and Position | Cristine Hernandez (MANAGING MEMBER) |
| Authorized Official Contact | 5104568143 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain Power Medical Center Llc 3430 E Flamingo Rd Ste 104 Las Vegas NV 89121-5070 Ph: (510) 456-8143 | Brain Power Medical Center Llc 3430 E Flamingo Rd Ste 104 Las Vegas NV 89121-5070 Ph: (510) 456-8143 |
| NPI Number | 1265109011 |
|---|---|
| Provider Enumeration Date | 08/27/2021 |
| Last Update Date | 02/08/2023 |
| Certification Date | 02/08/2023 |
| Medicare PECOS PAC ID | 4486051901 |
|---|---|
| Medicare Enrollment ID | O20210927002296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265109011 | NPI | - | NPPES |
| Provider Name | Roger B Reed |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1548252224 PECOS PAC ID: 3678469244 Enrollment ID: I20050902000030 |
| Provider Name | David Earl Linden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821062324 PECOS PAC ID: 1052228822 Enrollment ID: I20070220000037 |
| Provider Name | Stephen L Tam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689738478 PECOS PAC ID: 2567565492 Enrollment ID: I20070314000538 |
| Provider Name | Beverly Driskill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689762122 PECOS PAC ID: 0042303075 Enrollment ID: I20070907000392 |
| Provider Name | Enrico Estrella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033506498 PECOS PAC ID: 8527376334 Enrollment ID: I20150928002793 |
| Provider Name | Ajumobi C Agu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336453927 PECOS PAC ID: 9638446545 Enrollment ID: I20170525000225 |
| Provider Name | Gladys G Frondarina-beltran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922526474 PECOS PAC ID: 9830104827 Enrollment ID: I20171101002379 |
| Provider Name | Tiffany Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730683319 PECOS PAC ID: 5193087443 Enrollment ID: I20180326001149 |
| Provider Name | Ernesto J Isman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326535683 PECOS PAC ID: 9638408792 Enrollment ID: I20190916000816 |
| Provider Name | Atheni Degrano Sevilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215104377 PECOS PAC ID: 5294160990 Enrollment ID: I20200126000039 |
| Provider Name | Raymond F O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144472770 PECOS PAC ID: 6002245693 Enrollment ID: I20200402001112 |
| Provider Name | Kathleen S. Mayers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417582354 PECOS PAC ID: 9830505163 Enrollment ID: I20210310001958 |
| Provider Name | Mario Antonio Pacada |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114982535 PECOS PAC ID: 6901813591 Enrollment ID: I20210421001822 |
| Provider Name | Sheena Marie Spanskie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275179657 PECOS PAC ID: 6204238298 Enrollment ID: I20210713003869 |
| Provider Name | Mario Jose Valdes Espino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194497735 PECOS PAC ID: 4183017767 Enrollment ID: I20220202002192 |
| Provider Name | Annette Kee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710248505 PECOS PAC ID: 2668736067 Enrollment ID: I20230113001571 |
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