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General NPI Number Information
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NPI Number | 1831783141
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Entity Type | Organization
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Legal Business Name | MYTELEMDUSA LLC
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1703 CIVIC CENTER DR STE 6
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-7273
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Country | US
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Telephone | 702-874-4448
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Fax | 702-848-2809
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Provider Business Mailing Address
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Address Line | 1703 CIVIC CENTER DR STE 6
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-7273
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Country | US
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Telephone | 702-874-4448
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | SALINA RAMIREZ
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Credential |
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Telephone | 702-874-4448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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