| Family Tree Medical Center Llc | |
|
3510 E Tropicana Ave Ste # K Las Vegas NV 89121-7341 | |
| (702) 947-1000 | |
| (702) 947-1001 |
| Full Name | Family Tree Medical Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3510 E Tropicana Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Tony Gumina (OWNER) |
| Authorized Official Contact | 7029471000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Tree Medical Center Llc Po Box 231930 Las Vegas NV 89105-1930 Ph: (702) 947-1000 | Family Tree Medical Center Llc 3510 E Tropicana Ave Ste # K Las Vegas NV 89121-7341 Ph: (702) 947-1000 |
| NPI Number | 1508870445 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 04/30/2013 |
| Medicare PECOS PAC ID | 1355239203 |
|---|---|
| Medicare Enrollment ID | O20040310000960 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508870445 | NPI | - | NPPES |
| 002018528 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9897 (Nevada) | Primary |
| Provider Name | Antonio Gumina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245292440 PECOS PAC ID: 2668360520 Enrollment ID: I20040310001032 |
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