Health Advance Las Vegas Inc | |
9520 Green Vineyard Ave Las Vegas NV 89148-4578 | |
(702) 513-5507 | |
Not Available |
Full Name | Health Advance Las Vegas Inc |
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Speciality | Family Medicine |
Location | 9520 Green Vineyard Ave, Las Vegas, Nevada |
Authorized Official Name and Position | Alfred Theodore Carreon Maniago (NURSE PRACTITIONER) |
Authorized Official Contact | 7025135507 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Health Advance Las Vegas Inc 9520 Green Vineyard Ave Las Vegas NV 89148-4578 Ph: (702) 513-5507 | Health Advance Las Vegas Inc 9520 Green Vineyard Ave Las Vegas NV 89148-4578 Ph: (702) 513-5507 |
NPI Number | 1346961018 |
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Provider Enumeration Date | 09/09/2022 |
Last Update Date | 09/09/2022 |
Medicare PECOS PAC ID | 7911376322 |
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Medicare Enrollment ID | O20221207000493 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346961018 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Alfred Theodore Carreon Maniago |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255900155 PECOS PAC ID: 2860882586 Enrollment ID: I20211210001748 |
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