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NPI Code Detail

MEDICARE: YUDIVIAN PEREZ LEGRA

MEDICARE: YUDIVIAN PEREZ LEGRA
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 Attendant1235586306NV

General Provider Information

NPI Number : 1457216723
Entity Type Code : Individual
Provider Name (Legal Business Name) : YUDIVIAN PEREZ LEGRA
Provider Business Mailing Address
First Line : 1771 E FLAMINGO RD STE 114B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0839
Country : US
Telephone Number : 702-444-0772
Fax Number :
Provider Business Practice Location Address
First Line : 1771 E FLAMINGO RD STE 114B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0839
Country : US
Telephone Number : 702-444-0772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2025
Last Update Date : 12/18/2025

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Directions to “ YUDIVIAN PEREZ LEGRA ” Practice Location

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