MEDICARE: VIRTUDAZO APRN PLLC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1326901794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTUDAZO APRN PLLC

Provider Business Mailing Address
First Line	:	26 SNOW POND AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-5137
Country	:	US
Telephone Number	:	702-682-7267
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 SNOW POND AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-5137
Country	:	US
Telephone Number	:	702-682-7267
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOEL VIRTUDAZO
Credential	:	APRN
Telephone Number	:	702-682-7267

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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