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NPI Code Detail

MEDICARE: MISNELLI DIAZ-OSORIO

MEDICARE: MISNELLI DIAZ-OSORIO
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
1174400000XSpecialist

General Provider Information

NPI Number : 1417431024
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISNELLI DIAZ-OSORIO
Provider Business Mailing Address
First Line : 4714 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-4709
Country : US
Telephone Number : 702-685-7770
Fax Number :
Provider Business Practice Location Address
First Line : 4714 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-4709
Country : US
Telephone Number : 702-685-7770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2018
Last Update Date : 09/19/2018

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Directions to “ MISNELLI DIAZ-OSORIO ” 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.

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