MARISA C MEDINA MD PC NPI 1104013739

NPI Information

  • NPI: 1104013739
  • Provider Name: MARISA C MEDINA MD PC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 11201 S EASTERN #120
    HENDERSON, NV
    ZIP 89052
  • Phone: (702) 731-9711

Map and Directions

Get Directions

NPI Details

MARISA C MEDINA MD PC is a primary care clinic center in Henderson, NV. MARISA C MEDINA MD PC NPI is 1104013739. The provider is registered as an organization entity type.

The provider's business location address is:

11201 S EASTERN #120
HENDERSON, NV
ZIP 89052-200
Phone: (702) 731-9711
Fax: (702) 731-0096

The provider's authorized official is Marisa C Medina .
The authorized official title is Doctor and has the following contact phone number (702) 932-9824.

The enumeration date for this NPI number is 9/27/2007 and was last updated on 11/14/2007.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1V36263MEDICARE PINNEVADA
2F67354MEDICARE UPINNEVADA

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: 11/21/2025

NPI Synchronization or Removal

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.

Previous NPI
Next NPI