MEDICARE: NV 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
1	261Q00000X	Clinic/Center
2	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1497597975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NV ALWAYS YOUR DOCTOR LLC

Provider Business Mailing Address
First Line	:	4580 S EASTERN AVE STE 29B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6100
Country	:	US
Telephone Number	:	702-954-4915
Fax Number	:	725-204-0767

Provider Business Practice Location Address
First Line	:	4580 S EASTERN AVE STE 29B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6100
Country	:	US
Telephone Number	:	702-954-4915
Fax Number	:	725-204-0767

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MARIA TERESA REMEDIOS CASTELLO
Credential	:
Telephone Number	:	702-809-6428

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	06/07/2024

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Directions to “NV ALWAYS YOUR DOCTOR LLC ” Practice Location

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