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NPI Code Detail

MEDICARE: MARIO MANUEL QUINTERO SANCHEZ

MEDICARE:   MARIO MANUEL QUINTERO SANCHEZ
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 : 1396520623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIO MANUEL QUINTERO SANCHEZ
Provider Business Mailing Address
First Line : 4640 VEGAS VALLEY DR APT 1035
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-7910
Country : US
Telephone Number : 725-577-5476
Fax Number :
Provider Business Practice Location Address
First Line : 4640 VEGAS VALLEY DR APT 1035
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-7910
Country : US
Telephone Number : 725-577-5476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2023
Last Update Date : 08/25/2023

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Directions to “ MARIO MANUEL QUINTERO SANCHEZ ” Practice Location

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