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NPI Code Detail

MEDICARE: FELICIA MORENO

MEDICARE:   FELICIA  MORENO
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1740658988
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELICIA MORENO
Provider Business Mailing Address
First Line : 5428 EAGLE CLAW AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-7205
Country : US
Telephone Number : 702-673-8934
Fax Number :
Provider Business Practice Location Address
First Line : 5428 EAGLE CLAW AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-7205
Country : US
Telephone Number : 702-673-8934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2015
Last Update Date : 09/04/2015

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Directions to “ FELICIA MORENO ” Practice Location

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