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NPI Code Detail

MEDICARE: HEYSHA AFONSO

MEDICARE: HEYSHA AFONSO
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1326664467
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEYSHA AFONSO
Provider Business Mailing Address
First Line : 3376 S EASTERN AVE STE 188
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3386
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3376 S EASTERN AVE STE 188
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3386
Country : US
Telephone Number : 702-980-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2020
Last Update Date : 06/24/2020

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Directions to “ HEYSHA AFONSO ” Practice Location

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