MEDICARE: PEDRO DURAZO

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1225430531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO DURAZO

Provider Business Mailing Address
First Line	:	2349 RENAISSANCE DR STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6191
Country	:	US
Telephone Number	:	702-739-7716
Fax Number	:	702-597-2242

Provider Business Practice Location Address
First Line	:	2349 RENAISSANCE DR STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6191
Country	:	US
Telephone Number	:	702-739-7716
Fax Number	:	702-597-2242

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

Provider Enumeration Date	:	09/17/2014
Last Update Date	:	01/25/2026

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Directions to “ PEDRO DURAZO ” Practice Location

Language	Start Address	Practice Location

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