MEDICARE: ANUVISTA HEALTH 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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1467300335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANUVISTA HEALTH LLC

Provider Business Mailing Address
First Line	:	4820 EL ESCORIAL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6805
Country	:	US
Telephone Number	:	702-510-9229
Fax Number	:

Provider Business Practice Location Address
First Line	:	3430 E FLAMINGO RD STE 360F
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5003
Country	:	US
Telephone Number	:	702-510-9229
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REINIER MOLA GANDOL
Credential	:
Telephone Number	:	702-510-9229

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “ANUVISTA HEALTH LLC ” Practice Location

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