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NPI Code Detail

MEDICARE: MARK CANLAS ANTOLIN

MEDICARE: MARK CANLAS ANTOLIN
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 : 1275491581
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK CANLAS ANTOLIN
Provider Business Mailing Address
First Line : 2110 E FLAMINGO RD STE 315
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5193
Country : US
Telephone Number : 775-786-4999
Fax Number :
Provider Business Practice Location Address
First Line : 2110 E FLAMINGO RD STE 315
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5193
Country : US
Telephone Number : 775-786-4999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2026
Last Update Date : 01/14/2026

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Directions to “ MARK CANLAS ANTOLIN ” Practice Location

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