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NPI Code Detail

MEDICARE: DENISIS VARONA-CHALA

MEDICARE: DENISIS VARONA-CHALA
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
1374K00000XReligious Nonmedical Practitioner
2376J00000XHomemaker
3373H00000XDay Training/Habilitation Specialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12003733.054-122OTHERNVBUSINESS LICENSE NUMBER

General Provider Information

NPI Number : 1104394436
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENISIS VARONA-CHALA
Provider Business Mailing Address
First Line : 4714 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-4709
Country : US
Telephone Number : 702-685-7770
Fax Number :
Provider Business Practice Location Address
First Line : 4714 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-4709
Country : US
Telephone Number : 702-685-7770
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DENISIS VARONA CHALA
Credential :
Telephone Number : 702-296-2765
Provider Enumeration Date : 11/05/2018
Last Update Date : 11/05/2018

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Directions to “DENISIS VARONA-CHALA ” Practice Location

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