Healthcare Provider Details

I. General information

NPI: 1780476135
Provider Name (Legal Business Name): DESIREE PIZARRO REYES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CLOUD COVER AVE
HENDERSON NV
89002-6590
US

IV. Provider business mailing address

110 CLOUD COVER AVE
HENDERSON NV
89002-6590
US

V. Phone/Fax

Practice location:
  • Phone: 407-450-4349
  • Fax:
Mailing address:
  • Phone: 407-450-4349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number888381
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: