MEDICARE: LUIS F VALERA D.C.

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	111N00000X	Chiropractor	B01178	NV
2	111N00000X	Chiropractor	12565	CA
3	111N00000X	Chiropractor	CH4388	FL

General Provider Information

NPI Number	:	1194735605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS F VALERA D.C.

Provider Business Mailing Address
First Line	:	4680 S EASTERN AVE STE E
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6192
Country	:	US
Telephone Number	:	702-598-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	4680 S EASTERN AVE STE E
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6192
Country	:	US
Telephone Number	:	702-598-0500
Fax Number	:

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	04/29/2013

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