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NPI Code Detail

MEDICARE: JUAN ANTONIO CASTRO

MEDICARE: JUAN ANTONIO CASTRO
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 : 1164784302
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN ANTONIO CASTRO
Provider Business Mailing Address
First Line : 4001 BUTTE CIR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-4401
Country : US
Telephone Number : 702-438-3197
Fax Number :
Provider Business Practice Location Address
First Line : 2770 S MARYLAND PKWY STE 310
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-1566
Country : US
Telephone Number : 702-240-3800
Fax Number : 702-240-3001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2012
Last Update Date : 06/13/2012

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Directions to “ JUAN ANTONIO CASTRO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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