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NPI Code Detail

MEDICARE: MARIANA MARGO LUCERO DO, MS

MEDICARE: MARIANA MARGO LUCERO DO, MS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1073215653
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANA MARGO LUCERO DO, MS
Provider Business Mailing Address
First Line : 620 SHADOW LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4119
Country : US
Telephone Number : 702-388-8436
Fax Number :
Provider Business Practice Location Address
First Line : 620 SHADOW LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4119
Country : US
Telephone Number : 702-388-8436
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2023
Last Update Date : 06/30/2026

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Directions to “ MARIANA MARGO LUCERO DO, MS” Practice Location

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