MEDICARE: JOSE JAVIER AVILA RAMIREZ PA-C

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	363AM0700X	Medical Physician Assistant	PA860	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477641504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE JAVIER AVILA RAMIREZ PA-C

Provider Business Mailing Address
First Line	:	721 JACOBS LADDER PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-7540
Country	:	US
Telephone Number	:	702-580-1187
Fax Number	:

Provider Business Practice Location Address
First Line	:	7488 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2740
Country	:	US
Telephone Number	:	702-641-1240
Fax Number	:	702-920-8126

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	02/25/2026

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