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STA MARIA PEDIATRIC CLINIC LLC NPI 1104244011


NPI Information

NPI: 1104244011
Provider Name: STA MARIA PEDIATRIC CLINIC LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
730 N EASTERN AVE
STE 100
LAS VEGAS, NV
ZIP 89101
Phone: (702) 388-4428
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STA MARIA PEDIATRIC CLINIC LLC is a pediatrics in Las Vegas, NV. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. STA MARIA PEDIATRIC CLINIC LLC NPI is 1104244011. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

730 N EASTERN AVE
STE 100
LAS VEGAS, NV
ZIP 89101-885
Phone: (702) 388-4428
Fax: (702) 388-4312

The provider's authorized official is Teresita Lu Melocoton .
The authorized official title is Manager and has the following contact phone number (702) 388-4428.

The enumeration date for this NPI number is 3/29/2014 and was last updated on 4/8/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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