MEDICARE: AMELIA PULIDO

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	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1558191288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELIA PULIDO

Provider Business Mailing Address
First Line	:	8921 FIRST LADY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8921 FIRST LADY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1800
Country	:	US
Telephone Number	:	702-908-3326
Fax Number	:

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

Provider Enumeration Date	:	08/06/2024
Last Update Date	:	08/06/2024

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Directions to “ AMELIA PULIDO ” Practice Location

Language	Start Address	Practice Location

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