Healthcare Provider Details

I. General information

NPI: 1881309227
Provider Name (Legal Business Name): IHEALTH MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2023
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 W FLAMINGO RD UNIT 106
LAS VEGAS NV
89103-2234
US

IV. Provider business mailing address

6330 W FLAMINGO RD UNIT 106
LAS VEGAS NV
89103-2234
US

V. Phone/Fax

Practice location:
  • Phone: 702-885-6457
  • Fax: 702-701-8884
Mailing address:
  • Phone: 702-918-2800
  • Fax: 702-947-5352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: REYNANTE P VILLAHERMOSA
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 702-885-6457