MEDICARE: JOSE LUIS ZERON

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	246ZS0410X	Surgical Technologist

General Provider Information

NPI Number	:	1770707796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE LUIS ZERON

Provider Business Mailing Address
First Line	:	701 S TONOPAH DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4030
Country	:	US
Telephone Number	:	702-388-1008
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 S TONOPAH DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4030
Country	:	US
Telephone Number	:	702-388-1008
Fax Number	:

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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Directions to “ JOSE LUIS ZERON ” Practice Location

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