MEDICARE: DR. ARTURO HERNANDEZ PT, DPT, ATC

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	2255A2300X	Athletic Trainer		NV
2	225100000X	Physical Therapist	2858	NV

General Provider Information

NPI Number	:	1568897874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTURO HERNANDEZ PT, DPT, ATC

Provider Business Mailing Address
First Line	:	6535 N BUFFALO DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4077
Country	:	US
Telephone Number	:	702-522-7215
Fax Number	:

Provider Business Practice Location Address
First Line	:	6535 N BUFFALO DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131
Country	:	US
Telephone Number	:	702-522-7215
Fax Number	:

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

Provider Enumeration Date	:	09/05/2013
Last Update Date	:	11/14/2019

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