GUANAROCA MEDICAL CENTER INC NPI 1568032548

NPI Information

NPI: 1568032548
Provider Name: GUANAROCA MEDICAL CENTER INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 29D2257231

Address:
5130 S PECOS RD
LAS VEGAS, NV
ZIP 89120
Phone: (725) 205-3203
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GUANAROCA MEDICAL CENTER INC is a primary care clinic center in Las Vegas, NV. GUANAROCA MEDICAL CENTER INC NPI is 1568032548. The provider is registered as an organization entity type.

The provider's business location address is:

5130 S PECOS RD
LAS VEGAS, NV
ZIP 89120-201
Phone: (725) 205-3203
Fax: (725) 205-1861

The provider's authorized official is Alexeis Ares-gattorno .
The authorized official title is Ceo and has the following contact phone number (725) 400-6444.

The CLIA number assigned to this NPI record is 29D2257231 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2021 and was last updated on 10/13/2021.

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
1	261QP2300X	Clinic/Center	Primary Care			Yes

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
1	1568032548	MEDICAID	NEVADA

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

NPI Synchronization or Removal

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