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NPI Code Detail

MEDICARE: MARISA J AVILA

MEDICARE: MARISA J AVILA
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
2374U00000XHome Health Aide

General Provider Information

NPI Number : 1366206617
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISA J AVILA
Provider Business Mailing Address
First Line : 5693 RUBY CREEK DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89142-2052
Country : US
Telephone Number : 818-723-0149
Fax Number :
Provider Business Practice Location Address
First Line : 3930 HOWARD HUGHES PKWY STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-0946
Country : US
Telephone Number : 702-560-2192
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2024
Last Update Date : 05/12/2026

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Directions to “ MARISA J AVILA ” Practice Location

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