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NPI Code Detail

MEDICARE: REYMUNDO MACABABBAD II OTR/L

MEDICARE:   REYMUNDO  MACABABBAD II OTR/L
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
1225X00000XOccupational Therapist0825NV

General Provider Information

NPI Number : 1154582088
Entity Type Code : Individual
Provider Name (Legal Business Name) : REYMUNDO MACABABBAD II OTR/L
Provider Business Mailing Address
First Line : 10401 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1151
Country : US
Telephone Number : 702-360-2662
Fax Number :
Provider Business Practice Location Address
First Line : 10401 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1151
Country : US
Telephone Number : 702-360-2662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2008
Last Update Date : 06/23/2008

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Directions to “ REYMUNDO MACABABBAD II OTR/L” Practice Location

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