MARCIO REZENDE - NPI NUMBER 1073802757

Summary

Provider Name: MARCIO REZENDE

NPI Number: 1073802757

Clasification: Rehabilitation Practitioner (225400000X)

Address:
730 N EASTERN AVE
SUITE 110
LAS VEGAS, NV
ZIP 89101

Phone Number: (702) 586-1974



Detailed Information

Marcio Rezende is a rehabilitation practitioner in Las Vegas, NV. The provider is a health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. The assigned NPI number for this provider is 1073802757 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

730 N EASTERN AVE
SUITE 110
LAS VEGAS, NV
ZIP 89101-883
Phone: (702) 586-1974

The enumeration date for this NPI number is 4/1/2011 and was last updated on 4/1/2011.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 225400000X Rehabilitation Practitioner Yes

NPI Record

No. Field Name Field Value
1 NPI 1073802757
2 Entity Type Code 1
3 Provider Last Name Legal Name REZENDE
4 Provider First Name MARCIO
5 Provider First Line Business Practice Location Address 730 N EASTERN AVE
6 Provider Second Line Business Practice Location Address SUITE 110
7 Provider Business Practice Location Address City Name LAS VEGAS
8 Provider Business Practice Location Address State Name NV
9 Provider Business Practice Location Address Postal Code 891012883
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 7025861974
12 Provider Enumeration Date 4/1/2011
13 Last Update Date 4/1/2011
14 Provider Gender Code M
15 Healthcare Provider Taxonomy Code 1 225400000X
16 Healthcare Provider Primary Taxonomy Switch 1 Y
17 Is Sole Proprietor Y

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.