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General NPI Number Information
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NPI Number | 1588092514
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Entity Type | Organization
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Legal Business Name | GABEN GROUP LLC
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Dates
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Enumeration Date | 10/30/2013
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Last Update Date | 10/30/2013
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Provider Practice Location Address
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Address Line | 9017 S PECOS RD STE 4425
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City | HENDERSON
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State | NV
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Zip | 89074-6611
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Country | US
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Telephone | 702-988-9616
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Fax |
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Provider Business Mailing Address
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Address Line | 9017 S PECOS RD STE 4425
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City | HENDERSON
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State | NV
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Zip | 89074-6611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | KIRIL BENLIRO
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Credential |
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Telephone | 702-988-9616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN001014
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License Number State | NV
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