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 Field Definition 1
1 NPI 1073802757 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name REZENDE The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name MARCIO The first name of the provider, if the provider is an individual.
5 Provider First Line Business Practice Location Address 730 N EASTERN AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Second Line Business Practice Location Address SUITE 110 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name LAS VEGAS The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name NV The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 891012883 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 7025861974 The telephone number associated with the location address of the provider being identified.
12 Provider Enumeration Date 4/1/2011 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 4/1/2011 The date that a record was last updated or changed.
14 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
15 Healthcare Provider Taxonomy Code 1 225400000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
16 Healthcare Provider Primary Taxonomy Switch 1 Y
17 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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