MEDICARE: LEOPOLDO C MOZO

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	363LF0000X	Family Nurse Practitioner	825417	NV

General Provider Information

NPI Number	:	1497116354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEOPOLDO C MOZO

Provider Business Mailing Address
First Line	:	2870 S JONES BLVD
Second Line	:	115
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5643
Country	:	US
Telephone Number	:	786-262-6408
Fax Number	:

Provider Business Practice Location Address
First Line	:	7300 LA MONA CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0541
Country	:	US
Telephone Number	:	786-262-6408
Fax Number	:

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

Provider Enumeration Date	:	03/18/2016
Last Update Date	:	10/13/2023

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Directions to “ LEOPOLDO C MOZO ” Practice Location

Language	Start Address	Practice Location

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