MEDICARE: LODERA PADILLA

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1245889328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LODERA PADILLA

Provider Business Mailing Address
First Line	:	4732 CINDERELLA LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5799
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4850 W FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3705
Country	:	US
Telephone Number	:	702-871-9917
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2019
Last Update Date	:	09/10/2019

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Directions to “ LODERA PADILLA ” Practice Location

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