MEDICARE: DANIELA MORENO

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
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1437999281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELA MORENO

Provider Business Mailing Address
First Line	:	4928 VEGA LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1825
Country	:	US
Telephone Number	:	702-485-7678
Fax Number	:

Provider Business Practice Location Address
First Line	:	5400 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1825
Country	:	US
Telephone Number	:	702-853-3000
Fax Number	:

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

Provider Enumeration Date	:	05/29/2024
Last Update Date	:	05/29/2024

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Directions to “ DANIELA MORENO ” Practice Location

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