| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 09/09/2022 |
| Last Update Date | 09/09/2022 |
| Medicare PECOS PAC ID | 7911376322 |
|---|---|
| Medicare Enrollment ID | O20221207000493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346961018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Alfred Theodore Carreon Maniago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255900155 PECOS PAC ID: 2860882586 Enrollment ID: I20211210001748 |
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