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NPI Code Detail

MEDICARE: ROHALVIS PUERTAS CARPIO

MEDICARE:   ROHALVIS  PUERTAS CARPIO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1063001204
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROHALVIS PUERTAS CARPIO
Provider Business Mailing Address
First Line : 4660 KOVAL LN APT 34D
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-6949
Country : US
Telephone Number : 702-426-8774
Fax Number :
Provider Business Practice Location Address
First Line : 4660 S EASTERN AVE STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6139
Country : US
Telephone Number : 252-065-8207
Fax Number : 725-206-5824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2021
Last Update Date : 01/12/2021

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Directions to “ ROHALVIS PUERTAS CARPIO ” Practice Location

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