MEDICARE: ONNIEL PEREZ PORTUONDO

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	163WH0200X	Home Health Registered Nurse	900663	NV

General Provider Information

NPI Number	:	1720915838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONNIEL PEREZ PORTUONDO

Provider Business Mailing Address
First Line	:	5322 DEL GADO DR APT 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3566
Country	:	US
Telephone Number	:	702-820-6135
Fax Number	:

Provider Business Practice Location Address
First Line	:	5322 DEL GADO DR APT 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3566
Country	:	US
Telephone Number	:	702-820-6135
Fax Number	:

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

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ ONNIEL PEREZ PORTUONDO ” Practice Location

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