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General NPI Number Information
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NPI Number | 1306509971
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Entity Type | Individual
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Provider Name | MARK MAXILOM DE CARVALHO APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 732 S 6TH ST # 8014
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City | LAS VEGAS
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State | NV
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Zip | 89101-6948
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Country | US
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Telephone | 725-772-1939
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Fax |
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Provider Business Mailing Address
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Address Line | 732 S 6TH ST # 8014
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City | LAS VEGAS
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State | NV
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Zip | 89101-6948
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Country | US
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Telephone | 725-772-1939
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Fax | 702-442-4665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 86375
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1099927
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5571183
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ01261800
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | TPAN3116
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95025693
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP024314
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License Number State | PA
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 349083
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License Number State | NY
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Taxonomy #9
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277004816
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License Number State | IL
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12488
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License Number State | MN
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 319429
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License Number State | AZ
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Taxonomy #12
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 14244166-4405
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License Number State | UT
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Taxonomy #13
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 860179
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License Number State | NV
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Taxonomy #14
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.1001430-NP
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License Number State | CO
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Taxonomy #15
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 101.0138405TELE
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License Number State | VT
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