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NPI Code Detail

MEDICARE: MARCIO REZENDE

MEDICARE: MARCIO REZENDE
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
1106H00000XMarriage & Family Therapist01319NV

General Provider Information

NPI Number : 1073802757
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIO REZENDE
Provider Business Mailing Address
First Line : 7040 LAREDO ST STE K
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-3044
Country : US
Telephone Number : 702-331-4874
Fax Number :
Provider Business Practice Location Address
First Line : 7040 LAREDO ST STE K
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-3044
Country : US
Telephone Number : 702-331-4874
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2011
Last Update Date : 03/11/2020

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Directions to “ MARCIO REZENDE ” Practice Location

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