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General NPI Number Information
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NPI Number | 1497902639
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Entity Type | Individual
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Provider Name | HORACIO JOSE BERNARDO APRN
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Gender | Male
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 11/15/2019
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Provider Practice Location Address
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Address Line | 2000 WELLNESS WAY
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City | LAS VEGAS
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State | NV
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Zip | 89106-4113
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Country | US
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Telephone | 702-384-5101
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Fax | 702-387-0104
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Provider Business Mailing Address
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Address Line | PO BOX 81345
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City | LAS VEGAS
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State | NV
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Zip | 89180-1345
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Country | US
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Telephone | 702-384-5101
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Fax | 702-382-5675
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APN001238
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License Number State | NV
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