Healthcare Provider Details

I. General information

NPI: 1629806948
Provider Name (Legal Business Name): ANDREA CAROLINA RUIZRAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 SPRING MOUNTAIN RD STE 221
LAS VEGAS NV
89146-8720
US

IV. Provider business mailing address

5115 SPRING MOUNTAIN RD STE 221
LAS VEGAS NV
89146-8720
US

V. Phone/Fax

Practice location:
  • Phone: 702-861-9975
  • Fax: 888-691-9839
Mailing address:
  • Phone: 702-861-9975
  • Fax: 888-691-9839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: