MEDICARE: LISA MARIA GONZALEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	372600000X	Adult Companion
2	3747A0650X	Attendant Care Provider
3	376J00000X	Homemaker
4	372600000X	Adult Companion	NV

General Provider Information

NPI Number	:	1407722168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MARIA GONZALEZ

Provider Business Mailing Address
First Line	:	4485 PENNWOOD AVE APT 145
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-7212
Country	:	US
Telephone Number	:	702-253-1031
Fax Number	:	702-253-9474

Provider Business Practice Location Address
First Line	:	4485 PENNWOOD AVE APT 145
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-7212
Country	:	US
Telephone Number	:	702-253-1031
Fax Number	:	702-253-9474

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2025
Last Update Date	:	10/10/2025

Similar Medicare Providers

1871524025 — PETER L. GALLARELLO DPM
Practice Location Address:

1703 CIVIC CENTER DR , SUITE 3
NORTH LAS VEGAS, NV
89030-7212

Practice Phone: 702-791-3668
Practice Fax:

1669791794 — PHYSICIAN TO YOU LLC
Practice Location Address:

3571 E SUNSET RD , STE 112
LAS VEGAS, NV
89120-7212

Practice Phone: 702-630-0895
Practice Fax:

1306192430 — PETER L GALLARELLO DPM PLLC
Practice Location Address:

1703 CIVIC CENTER DR , #3
N LAS VEGAS, NV
89030-7212

Practice Phone: 702-791-3668
Practice Fax: 702-452-3668

1225388010 — NEDRA SHIELDS
Practice Location Address:

7212 ELITE CT
LAS VEGAS, NV
89129-5988

Practice Phone: 702-372-7964
Practice Fax:

1285019646 — EXTREMITY RECONSTRUCTIVE LLC
Practice Location Address:

1703 CIVIC CENTER DR , SUITE #3
NORTH LAS VEGAS, NV
89030-7212

Practice Phone: 702-388-1006
Practice Fax: 702-388-1751

1558737015 — NINA DAVIS
Practice Location Address:

6023 GLITTER GOLD CT
N LAS VEGAS, NV
89031-7212

Practice Phone: 619-606-8627
Practice Fax:

Directions to “ LISA MARIA GONZALEZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.