Healthcare Provider Details

I. General information

NPI: 1508630542
Provider Name (Legal Business Name): MED-CARE PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 E FLAMINGO RD STE 218
LAS VEGAS NV
89119-5124
US

IV. Provider business mailing address

2121 E FLAMINGO RD STE 218
LAS VEGAS NV
89119-5124
US

V. Phone/Fax

Practice location:
  • Phone: 702-444-1002
  • Fax:
Mailing address:
  • Phone: 702-000-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. OSMEL VILLAREAL
Title or Position: DIRECTOR OF BUSINESS OPERATIONS
Credential:
Phone: 702-000-0000