MEDICARE: MISS ALMA REYES PAGUIO RN

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	146D00000X	Personal Emergency Response Attendant
2	146N00000X	Basic Emergency Medical Technician

General Provider Information

NPI Number	:	1467690065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ALMA REYES PAGUIO RN

Provider Business Mailing Address
First Line	:	2301 S WOLFSNARE DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3328
Country	:	US
Telephone Number	:	757-401-8153
Fax Number	:	757-301-9821

Provider Business Practice Location Address
First Line	:	2301 S WOLFSNARE DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3328
Country	:	US
Telephone Number	:	757-401-8153
Fax Number	:	757-301-9821

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

Provider Enumeration Date	:	02/04/2009
Last Update Date	:	02/04/2009

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