MEDICARE: LILIAN CASTELLVI

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	163WP0200X	Pediatric Registered Nurse	856851	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1702927587	OTHER	NV	DL

General Provider Information

NPI Number	:	1093291783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIAN CASTELLVI

Provider Business Mailing Address
First Line	:	6100 EMPIRE CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1451
Country	:	US
Telephone Number	:	702-624-8522
Fax Number	:

Provider Business Practice Location Address
First Line	:	6100 EMPIRE CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1451
Country	:	US
Telephone Number	:	702-624-8522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2018
Last Update Date	:	08/08/2024

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Directions to “ LILIAN CASTELLVI ” Practice Location

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