Healthcare Provider Details

I. General information

NPI: 1801910120
Provider Name (Legal Business Name): MARIBEL E MONROE MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 PROFESSIONAL CT STE 110
LAS VEGAS NV
89128-0835
US

IV. Provider business mailing address

2480 PROFESSIONAL CT STE 110
LAS VEGAS NV
89128-0835
US

V. Phone/Fax

Practice location:
  • Phone: 702-868-9100
  • Fax: 708-868-9101
Mailing address:
  • Phone: 702-868-9100
  • Fax: 708-868-9101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIBEL E MONROE
Title or Position: PRESIDENT
Credential: MD
Phone: 708-868-9100