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NPI Code Detail

MEDICARE: MARTHA ELBA CAMERO GONZALEZ

MEDICARE:   MARTHA ELBA CAMERO GONZALEZ
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1376849695
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA ELBA CAMERO GONZALEZ
Provider Business Mailing Address
First Line : 7575 W WASHINGTON AVE
Second Line : # 127-145
City : LAS VEGAS
State : NV
Zip : 89128-4333
Country : US
Telephone Number : 702-403-0514
Fax Number :
Provider Business Practice Location Address
First Line : 7575 W WASHINGTON AVE
Second Line : # 127-145
City : LAS VEGAS
State : NV
Zip : 89128-4333
Country : US
Telephone Number : 702-403-0514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2011
Last Update Date : 02/03/2011

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Directions to “ MARTHA ELBA CAMERO GONZALEZ ” Practice Location

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