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NPI Code Detail

MEDICARE: AV RESUELLO MEDICAL CORPORATION

MEDICARE: AV RESUELLO MEDICAL CORPORATION
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
1208000000XPediatrics Physician8004NV
2207R00000XInternal Medicine Physician8004NV

Other Identifiers

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

General Provider Information

NPI Number : 1184964306
Entity Type Code : Organization
Provider Name (Legal Business Name) : AV RESUELLO MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 1300 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3310
Country : US
Telephone Number : 702-385-4929
Fax Number : 702-385-4457
Provider Business Practice Location Address
First Line : 1300 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3310
Country : US
Telephone Number : 702-385-4929
Fax Number : 702-385-4457
Authorized Official
Title or Position : PRESIDENT
Name : MS. ADELAIDA VALERIO RESUELLO
Credential : MD
Telephone Number : 702-385-4929
Provider Enumeration Date : 02/25/2013
Last Update Date : 02/25/2013

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Directions to “AV RESUELLO MEDICAL CORPORATION ” Practice Location

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