| Optima Healthcare | |
|
6859 S Eastern Ave Ste 103 Las Vegas NV 89119-0003 | |
| (707) 236-2078 | |
| Not Available |
| Full Name | Optima Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 6859 S Eastern Ave Ste 103, Las Vegas, Nevada |
| Authorized Official Name and Position | Marivic Banal (OWNER) |
| Authorized Official Contact | 7022362078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optima Healthcare 6859 S Eastern Ave Ste 103 Las Vegas NV 89119-0003 Ph: () - | Optima Healthcare 6859 S Eastern Ave Ste 103 Las Vegas NV 89119-0003 Ph: (707) 236-2078 |
| NPI Number | 1598523276 |
|---|---|
| Provider Enumeration Date | 03/07/2024 |
| Last Update Date | 03/07/2024 |
| Medicare PECOS PAC ID | 0941742167 |
|---|---|
| Medicare Enrollment ID | O20240604000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598523276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Krisel Anne Garcia Aquino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164297370 PECOS PAC ID: 5294171427 Enrollment ID: I20240311002728 |
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