MEDICARE: CLINICA MEDICA DEL CANYON GATE

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	207R00000X	Internal Medicine Physician	12464	NV

General Provider Information

NPI Number	:	1568764140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA MEDICA DEL CANYON GATE

Provider Business Mailing Address
First Line	:	2929 N UNIVERSITY DR
Second Line	:	SUITE# 110
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-5081
Country	:	US
Telephone Number	:	954-656-8855
Fax Number	:	954-656-8856

Provider Business Practice Location Address
First Line	:	2832 E LAKE MEAD BLVD
Second Line	:	SUITE# E
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6550
Country	:	US
Telephone Number	:	702-649-5155
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	VERONICA COLON
Credential	:
Telephone Number	:	954-656-8855

Provider Enumeration Date	:	12/02/2010
Last Update Date	:	12/02/2010

Similar Medicare Providers

1437229598 — DR. THOMAS RAYMOND VAUGHN JR. D.C.
Practice Location Address:

2832 E LAKE MEAD BLVD STE F
NORTH LAS VEGAS, NV
89030-6550

Practice Phone: 702-369-7222
Practice Fax:

1891126157 — CLINICA MEDICA VARGAS & ALMONTE
Practice Location Address:

2832 E LAKE MEAD BLVD STE E
NORTH LAS VEGAS, NV
89030-6550

Practice Phone: 702-476-9600
Practice Fax:

1437534534 — SANTA FE MANAGEMENT LLC
Practice Location Address:

2828 E LAKE MEAD BLVD
NORTH LAS VEGAS, NV
89030-6550

Practice Phone: 702-218-1142
Practice Fax: 702-224-2104

1265818579 — VARGAS MD PC
Practice Location Address:

2828 E LAKE MEAD BLVD
NORTH LAS VEGAS, NV
89030-6550

Practice Phone: 702-480-0377
Practice Fax: 702-224-2104

1245675040 — MR. SHAWN ADRIAN PILGRIM
Practice Location Address:

3144 MANTI PEAK AVE
NORTH LAS VEGAS, NV
89081-6550

Practice Phone: 702-430-0481
Practice Fax:

1821194903 — MS. SUE E DANIEL MFT
Practice Location Address:

6550 S PECOS RD , BLDG B SUITE 127
LAS VEGAS, NV
89120

Practice Phone: 702-898-1711
Practice Fax: 775-537-2388

Directions to “CLINICA MEDICA DEL CANYON GATE ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.