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NPI Code Detail

MEDICARE: JEFFREY AQUINO BSN, RN, MS, OT

MEDICARE: JEFFREY AQUINO BSN, RN, MS, OT
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
1225X00000XOccupational TherapistOT-2230NV
2163WH0200XHome Health Registered Nurse821347NV

General Provider Information

NPI Number : 1821558883
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY AQUINO BSN, RN, MS, OT
Provider Business Mailing Address
First Line : 6045 S FORT APACHE RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5565
Country : US
Telephone Number : 702-948-5095
Fax Number :
Provider Business Practice Location Address
First Line : 6045 S FORT APACHE RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5565
Country : US
Telephone Number : 702-948-5095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2019
Last Update Date : 03/06/2024

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