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NPI Code Detail

MEDICARE: LUCIA GOMEZ

MEDICARE: LUCIA GOMEZ
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1104555200
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCIA GOMEZ
Provider Business Mailing Address
First Line : 2810 W CHARLESTON BLVD STE 44
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1905
Country : US
Telephone Number : 702-485-1888
Fax Number : 702-485-1890
Provider Business Practice Location Address
First Line : 2810 W CHARLESTON BLVD STE 44
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1905
Country : US
Telephone Number : 702-485-1888
Fax Number : 702-485-1890
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2022
Last Update Date : 06/06/2022

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Directions to “ LUCIA GOMEZ ” Practice Location

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