MEDICARE: GUITA TABASSI DO LTD

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner
2	207V00000X	Obstetrics & Gynecology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841342102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUITA TABASSI DO LTD

Provider Business Mailing Address
First Line	:	6080 S FORT APACHE RD
Second Line	:	SUITE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5616
Country	:	US
Telephone Number	:	702-871-0303
Fax Number	:	702-562-0054

Provider Business Practice Location Address
First Line	:	6080 S FORT APACHE RD
Second Line	:	SUITE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5616
Country	:	US
Telephone Number	:	702-871-0303
Fax Number	:	702-562-0054

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GUITA TABASSI
Credential	:	DO
Telephone Number	:	702-871-0303

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	08/25/2008

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