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NPI Code Detail

MEDICARE: NEVADA ALWAYS YOUR DOCTOR LLC.

MEDICARE: NEVADA ALWAYS YOUR DOCTOR LLC.
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
1261Q00000XClinic/Center
2207QA0505XAdult Medicine Physician

General Provider Information

NPI Number : 1497432793
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEVADA ALWAYS YOUR DOCTOR LLC.
Provider Business Mailing Address
First Line : 4580 S EASTERN AVE STE 29
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6100
Country : US
Telephone Number : 702-826-0956
Fax Number :
Provider Business Practice Location Address
First Line : 4580 S EASTERN AVE STE 29
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6100
Country : US
Telephone Number : 702-826-0956
Fax Number :
Authorized Official
Title or Position : OWNER
Name : THERESA SIMPORIOS MONTECILLO
Credential : NURSE PRACTITIONER
Telephone Number : 702-826-0959
Provider Enumeration Date : 06/29/2023
Last Update Date : 06/29/2023

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Directions to “NEVADA ALWAYS YOUR DOCTOR LLC. ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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