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General NPI Number Information
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NPI Number | 1063236651
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Entity Type | Organization
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Legal Business Name | EXPERTISE WELLNESS CENTER LLC
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 5440 W SAHARA AVE STE 202
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City | LAS VEGAS
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State | NV
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Zip | 89146-0361
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Country | US
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Telephone | 702-480-5799
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 W SAHARA AVE STE 202
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City | LAS VEGAS
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State | NV
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Zip | 89146-0361
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Country | US
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Telephone | 702-480-5799
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DENISIS VERONA
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Credential | OWNER
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Telephone | 702-296-4844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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