Healthcare Provider Details

I. General information

NPI: 1689495111
Provider Name (Legal Business Name): MELVIN PANLILIO RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6462 N LOSEE RD STE 135
NORTH LAS VEGAS NV
89086-0104
US

IV. Provider business mailing address

6462 N LOSEE RD STE 135
NORTH LAS VEGAS NV
89086-0104
US

V. Phone/Fax

Practice location:
  • Phone: 702-625-4809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: