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NPI Code Detail

MEDICARE: MARCO HERNANDEZ DPT

MEDICARE:   MARCO  HERNANDEZ  DPT
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
1225100000XPhysical Therapist1000002-322NV

General Provider Information

NPI Number : 1477920536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCO HERNANDEZ DPT
Provider Business Mailing Address
First Line : 7195 ADVANCED WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-3691
Country : US
Telephone Number : 702-740-5327
Fax Number : 702-740-5328
Provider Business Practice Location Address
First Line : 7189 ADVANCED WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-3691
Country : US
Telephone Number : 702-740-5327
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2015
Last Update Date : 07/12/2021

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Directions to “ MARCO HERNANDEZ DPT” Practice Location

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