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NPI Code Detail

MEDICARE: NINA V NATION PA-C

MEDICARE: NINA V NATION PA-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
1363A00000XPhysician AssistantPA777NV

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 : 1255321774
Entity Type Code : Individual
Provider Name (Legal Business Name) : NINA V NATION PA-C
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2875 S NELLIS BLVD STE 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-2087
Country : US
Telephone Number : 702-843-2420
Fax Number : 833-749-0351
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 02/13/2026

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Directions to “ NINA V NATION PA-C” Practice Location

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