MEDICARE: GILBERT OLIVIANO ARCIOSA

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	3140N1450X	Pediatric Skilled Nursing Facility

General Provider Information

NPI Number	:	1871109082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILBERT OLIVIANO ARCIOSA

Provider Business Mailing Address
First Line	:	8006 ARCADIAN LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-3700
Country	:	US
Telephone Number	:	510-921-0686
Fax Number	:

Provider Business Practice Location Address
First Line	:	1064 E SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3220
Country	:	US
Telephone Number	:	725-244-4182
Fax Number	:

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

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	09/22/2020

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