MEDICARE: APLO HEALTH AND AESTHETICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner

General Provider Information

NPI Number	:	1104473248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APLO HEALTH AND AESTHETICS LLC

Provider Business Mailing Address
First Line	:	10881 WOODS HOLE BAY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1457
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2831 BUSINESS PARK CT STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9010
Country	:	US
Telephone Number	:	702-713-5347
Fax Number	:	844-858-9345

Authorized Official
Title or Position	:	APRN
Name	:	MRS. JENESA AGUILUZ-DIZON
Credential	:
Telephone Number	:	509-713-4619

Provider Enumeration Date	:	08/22/2019
Last Update Date	:	02/27/2020

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Directions to “APLO HEALTH AND AESTHETICS LLC ” Practice Location

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