| Elite Infectious Disease Of Nevada Pllc | |
|
3280 N Rainbow Blvd Ste 110-a Las Vegas NV 89108-5011 | |
| (725) 253-4055 | |
| Not Available |
| Full Name | Elite Infectious Disease Of Nevada Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3280 N Rainbow Blvd Ste 110-a, Las Vegas, Nevada |
| Authorized Official Name and Position | Lea Diola (PRACTICE OWNER) |
| Authorized Official Contact | 7252534055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Infectious Disease Of Nevada Pllc 6765 W Charleston Blvd Ste 170 Las Vegas NV 89146-2001 Ph: () - | Elite Infectious Disease Of Nevada Pllc 3280 N Rainbow Blvd Ste 110-a Las Vegas NV 89108-5011 Ph: (725) 253-4055 |
| NPI Number | 1174369623 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 07/03/2024 |
| Medicare PECOS PAC ID | 9335680867 |
|---|---|
| Medicare Enrollment ID | O20240924001276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174369623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| 363LG0600X | Nurse Practitioner - Gerontology | (* (Not Available)) | Secondary |
| Provider Name | Ricardo Asuncion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336782036 PECOS PAC ID: 6901236496 Enrollment ID: I20200424000262 |
| Provider Name | Lea J Diola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073115614 PECOS PAC ID: 6305217530 Enrollment ID: I20230125002032 |
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