Healthcare Provider Details

I. General information

NPI: 1124939996
Provider Name (Legal Business Name): BREEZE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 DEEP VALLEY AVE
NORTH LAS VEGAS NV
89084-4004
US

IV. Provider business mailing address

1229 DEEP VALLEY AVE
NORTH LAS VEGAS NV
89084-4004
US

V. Phone/Fax

Practice location:
  • Phone: 702-541-3735
  • Fax:
Mailing address:
  • Phone: 702-541-3735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YANDY POMARES MORENO
Title or Position: OWNER
Credential:
Phone: 702-541-3735