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NPI Code Detail

MEDICARE: PDA MEDHELP LLC

MEDICARE: PDA MEDHELP LLC
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
1363LF0000XFamily Nurse Practitioner
2363LF0000XFamily Nurse PractitionerNV

General Provider Information

NPI Number : 1417397183
Entity Type Code : Organization
Provider Name (Legal Business Name) : PDA MEDHELP LLC
Provider Business Mailing Address
First Line : PO BOX 14804
Second Line :
City : LAS VEGAS
State : NV
Zip : 89114-4804
Country : US
Telephone Number : 702-595-9855
Fax Number : 702-453-7005
Provider Business Practice Location Address
First Line : 2104 CALLE DE ESPANA
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-4013
Country : US
Telephone Number : 702-595-9855
Fax Number : 702-453-7005
Authorized Official
Title or Position : OWNER
Name : PILAR DIAZ ARABIA
Credential : APN
Telephone Number : 702-595-9855
Provider Enumeration Date : 06/26/2013
Last Update Date : 12/05/2014

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