Healthcare Provider Details

I. General information

NPI: 1689401044
Provider Name (Legal Business Name): MIGUEL ESQUIERDO GABRINO BSN, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 E ALEXANDER RD
LAS VEGAS NV
89115-0290
US

IV. Provider business mailing address

3580 E ALEXANDER RD
LAS VEGAS NV
89115-0290
US

V. Phone/Fax

Practice location:
  • Phone: 702-849-5928
  • Fax:
Mailing address:
  • Phone: 702-849-5928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number868096
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: