MEDICARE: M3L MEDICAL GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363AM0700X	Medical Physician Assistant
3	261QU0200X	Urgent Care Clinic/Center
4	363L00000X	Nurse Practitioner
5	261QP2300X	Primary Care Clinic/Center
6	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1447916044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M3L MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	5625 LOSEE RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-2523
Country	:	US
Telephone Number	:	702-552-1818
Fax Number	:

Provider Business Practice Location Address
First Line	:	5625 LOSEE RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-2523
Country	:	US
Telephone Number	:	702-552-1818
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	RAYMUNDO MANUEL
Credential	:
Telephone Number	:	702-686-8180

Provider Enumeration Date	:	11/09/2021
Last Update Date	:	11/10/2025

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