| Ahmed Jaradat Md Pllc | |
|
2075 E Flamingo Rd Las Vegas NV 89119-5188 | |
| (702) 733-8800 | |
| Not Available |
| Full Name | Ahmed Jaradat Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2075 E Flamingo Rd, Las Vegas, Nevada |
| Authorized Official Name and Position | Lauren Minter (AGENT) |
| Authorized Official Contact | 7022563637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ahmed Jaradat Md Pllc 3022 S Durango Dr Ste 100 Las Vegas NV 89117-4440 Ph: () - | Ahmed Jaradat Md Pllc 2075 E Flamingo Rd Las Vegas NV 89119-5188 Ph: (702) 733-8800 |
| NPI Number | 1669991006 |
|---|---|
| Provider Enumeration Date | 09/18/2017 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 3274809124 |
|---|---|
| Medicare Enrollment ID | O20171023000149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669991006 | NPI | - | NPPES |
| 82-24023801 | Other | NV | TIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 15111 (Nevada) | Primary |
| Provider Name | Ahmed A Jaradat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780994426 PECOS PAC ID: 3274760814 Enrollment ID: I20140805001280 |
| Provider Name | Gloria Santiaguel Mandel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528566460 PECOS PAC ID: 0143582965 Enrollment ID: I20180314002391 |
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