MEDICARE: KAN-DI-KI LLC

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
1	291U00000X	Clinical Medical Laboratory	5562LIC-4	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01138750	OTHER	NV	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073859930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAN-DI-KI LLC

Provider Business Mailing Address
First Line	:	930 RIDGEBROOK RD FL 3
Second Line	:
City	:	SPARKS
State	:	MD
Zip	:	21152-9481
Country	:	US
Telephone Number	:	800-786-8015
Fax Number	:

Provider Business Practice Location Address
First Line	:	7355 PRAIRIE FALCON RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0801
Country	:	US
Telephone Number	:	702-982-0533
Fax Number	:	702-982-0991

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL/CFO
Name	:	BRIAN C CUOMO
Credential	:
Telephone Number	:	800-786-8015

Provider Enumeration Date	:	12/21/2012
Last Update Date	:	02/07/2024

Similar Medicare Providers

1811210289 — KAN-DI-KI, LLC
Practice Location Address:

7355 PRAIRIE FALCON RD
LAS VEGAS, NV
89128-0801

Practice Phone: 702-589-9795
Practice Fax: 443-842-7264

1700198330 — KAN-DI-KI LLC
Practice Location Address:

7355 PRAIRIE FALCON RD
LAS VEGAS, NV
89128-0801

Practice Phone: 702-589-9795
Practice Fax: 443-842-7264

1487110342 — IDALMIS GALLO-HIDALGO
Practice Location Address:

6379 CANYON DAWN AVE
LAS VEGAS, NV
89108-0801

Practice Phone: 702-759-9945
Practice Fax:

1003583048 — LAURA MARIA GARCIA GALLO
Practice Location Address:

6379 CANYON DAWN AVE
LAS VEGAS, NV
89108-0801

Practice Phone: 702-417-2987
Practice Fax:

1346465283 — CONDOLEON SURGERY LTD.
Practice Location Address:

3150 N TENAYA WAY , SUITE 630
LAS VEGAS, NV
89128-0443

Practice Phone: 702-562-0801
Practice Fax: 702-562-0802

1194120253 — INDIVIDUALIZED INTERNAL MEDICINE
Practice Location Address:

8463 W LAKE MEAD BLVD
LAS VEGAS, NV
89128-7638

Practice Phone: 702-304-0854
Practice Fax: 702-256-2821

Directions to “KAN-DI-KI LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.