MEDICARE: RAYMOND VALDEZ

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1255098273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND VALDEZ

Provider Business Mailing Address
First Line	:	5410 LINDERO PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-2713
Country	:	US
Telephone Number	:	702-490-2282
Fax Number	:

Provider Business Practice Location Address
First Line	:	5410 LINDERO PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-2713
Country	:	US
Telephone Number	:	702-490-2282
Fax Number	:

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

Provider Enumeration Date	:	11/24/2021
Last Update Date	:	11/24/2021

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Directions to “ RAYMOND VALDEZ ” Practice Location

Language	Start Address	Practice Location

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