Healthcare Provider Details

I. General information

NPI: 1003660176
Provider Name (Legal Business Name): PROSSAVID HEALTH CARE CENTER L C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 E FLAMINGO RD STE 3
LAS VEGAS NV
89121-7440
US

IV. Provider business mailing address

3365 E FLAMINGO RD STE 3
LAS VEGAS NV
89121-7440
US

V. Phone/Fax

Practice location:
  • Phone: 702-764-7765
  • Fax: 725-205-8557
Mailing address:
  • Phone: 702-764-7765
  • Fax: 702-552-5160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ADRIAN CASTILLO MILANES
Title or Position: OWNER
Credential: DNP, APRN, FNP-C
Phone: 702-764-7765